| Locations |
Click to select the locations that contain the data for the activity.
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| Date Range |
Enter dates in the Start Date and End Date fields to specify a date range for the activity.
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| Juror Donations |
In the Number Filed field, type the number of juror donations filed. In the Total Donated field, type the total amount of the donations.
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| a. T Code |
Type the number in the a. T Code field on the pre-printed report.
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| b. |
Type any information printed in section b. on the pre-printed report.
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| c. County Identification Number |
Type any information printed in section c. on the pre-printed report.
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| d. County name and mailing address |
In Line 1 – 5, type the data as it is displayed in section d. of the pre-printed report, unless the address has changed. If the address has changed, enter the new address.
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| e. Due date of report |
Enter the date when the report is due as displayed in section e. of the pre-printed report.
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| f. Report for quarter ending |
Enter the date when the quarter ends as displayed in section f. of the pre-printed report.
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| g. |
Type any information printed in section g. on the pre-printed report.
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| h. |
Select the Address has changed check box if the address has changed from the address in section h. on the pre-printed report.
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| i. |
Type any information printed in section i. on the pre-printed report.
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| j. |
Type any information printed in section j. on the pre-printed report.
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| k. |
Type any information printed in section k. on the pre-printed report.
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| l. |
Type any information printed in section l. on the pre-printed report.
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| County Name |
Type the county name as it is printed in the footer of the pre-printed report. |
| Period |
Type the period as it is printed in the footer of the pre-printed report. |
| Authorized Agent |
Type the name, title, and phone number of the agent authorized to sign this form in the respective fields. |
| Report Options |
Select the Include Detail check box to generate a detailed comma-separated values version of the report.
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