"Yes, I identify as black or African-American, but I am not a Negro," Raeana Roberson said after jury duty Monday.
Roberson crossed off Negro, and wrote "offensive! It's 2014!"
She also posted a picture of the form on her Facebook page.
Per judicial law, every prospective juror must fill out paperwork for the collection of demographic information.
Arlene Hackel, a spokeswoman for the New York State Office of Court Administration, said the race categories come from the U.S. Census Bureau.
Former director of the U.S. Census Bureau Robert Groves said the word Negro was used in the 2000 census, after research indicated that 56,000 people identified themselves as Negro.
"I am confident that the intent of my colleagues in using the same wording as Census 2000 was to make sure as many people as possible saw words that matched their self-identities. Full inclusiveness was the goal," Groves wrote.
The Census Bureau has stopped using the term at the start of 2014.
New York courts will stop using the term soon, Hackel said.