{
  "document_metadata": {
    "page_number": "28 of 32",
    "document_number": "462",
    "date": "11/15/21",
    "document_type": "Jury Questionnaire",
    "has_handwriting": false,
    "has_stamps": false
  },
  "full_text": "Case 1:20-cr-00330-PAE Document 462 Filed 11/15/21 Page 28 of 32\nJuror ID:_____\n\nDECLARATION\nI, Juror Number _____ declare under penalty of perjury that the foregoing answers set forth in this Jury Questionnaire are true and correct to the best of my knowledge and belief. I have not discussed my answers with others, or received assistance in completing the questionnaire.\nSigned this _____ day of November, 2021\n\nDO NOT WRITE YOUR NAME. PLEASE SIGN USING YOUR JUROR NUMBER.\n\n-27-\nDOJ-OGR-00007044",
  "text_blocks": [
    {
      "type": "printed",
      "content": "Case 1:20-cr-00330-PAE Document 462 Filed 11/15/21 Page 28 of 32",
      "position": "header"
    },
    {
      "type": "printed",
      "content": "Juror ID:_____",
      "position": "header"
    },
    {
      "type": "printed",
      "content": "DECLARATION",
      "position": "top"
    },
    {
      "type": "printed",
      "content": "I, Juror Number _____ declare under penalty of perjury that the foregoing answers set forth in this Jury Questionnaire are true and correct to the best of my knowledge and belief. I have not discussed my answers with others, or received assistance in completing the questionnaire.",
      "position": "middle"
    },
    {
      "type": "printed",
      "content": "Signed this _____ day of November, 2021",
      "position": "middle"
    },
    {
      "type": "printed",
      "content": "DO NOT WRITE YOUR NAME. PLEASE SIGN USING YOUR JUROR NUMBER.",
      "position": "middle"
    },
    {
      "type": "printed",
      "content": "-27-",
      "position": "footer"
    },
    {
      "type": "printed",
      "content": "DOJ-OGR-00007044",
      "position": "footer"
    }
  ],
  "entities": {
    "people": [],
    "organizations": [
      "DOJ"
    ],
    "locations": [],
    "dates": [
      "11/15/21",
      "November, 2021"
    ],
    "reference_numbers": [
      "1:20-cr-00330-PAE",
      "462",
      "DOJ-OGR-00007044"
    ]
  },
  "additional_notes": "The document is a jury questionnaire declaration page. It contains a declaration statement to be signed by a juror, with instructions not to write their name but to sign using their juror number. The page is part of a larger document (Document 462) in a court case (Case 1:20-cr-00330-PAE)."
}