The Nebraska Juror Qualification Form, attached as Appendix A to this rule, has been adopted by the Nebraska Supreme Court pursuant to Neb. Rev. Stat. § 25-1629.01. All district and county courts shall use the attached form when the use of a juror qualification form is required by statute unless a request for approval of any amendments to such form has been approved by the Supreme Court. Such requests shall be submitted in writing and on a disk or CD in a Microsoft Word compatible format to the Clerk of the Supreme Court for submission to the Court. Any language to be added to the form shall be underscored and any language to be deleted from the form shall be overstruck.