Massachusetts General Laws Part III. Courts, Judicial Officers and Proceedings in Civil Cases (Ch. 211-262) Ch. 234A, § 22

The office of jury commissioner shall provide a confidential juror questionnaire to each prospective juror. The information elicited by the questionnaire shall be such information as is ordinarily raised in voir dire examinations of jurors, including the juror's name, sex, age, residence, marital status, number and ages of children, education level, occupation, employment address, spouse's occupation, spouse's employment address, previous service as a juror, present or past involvement as a party to civil or criminal litigation, relationship to a police or law enforcement officer, and such other information as the jury commissioner deems appropriate. The questionnaire shall contain the prospective juror's declaration that the information supplied in the completed questionnaire is true to the best of his knowledge and that he understands that a wilful misrepresentation of a material fact therein is a crime, which, upon conviction, may be punished by a fine of not more than two thousand dollars. Immediately below such declaration, the questionnaire shall contain a place for the signature of the juror. A notice of the confidentiality of the completed questionnaire shall appear prominently on the face of the questionnaire.