STATE OF SOUTH CAROLINA COUNTY OF _________________
JUROR: _________________________________
) ) ) ) )
___________________________ CIVIL CASE NUMBER JURY DUTY CERTIFICATION
I certify that the above named juror was summoned and did appear for jury service; and is therefore entitled to the following: $ ___________ for compensation $ ___________ for service as a juror in the actions named below:
__________________________ vs. ___________________________ __________________________ vs. ___________________________
In a total amount of $ ____________.
Dated:
MAGISTRATE
SCCA/723 (Amended 05/2008)