Escambia County Jury Excusal Form PDF Details

The Escambia County Jury Excusal form, carefully laid out by Pam Childers, the Clerk of the Circuit Court and Comptroller, serves as a crucial document for those summoned for jury duty within Escambia County. It provides a framework for incoming jurors to seek excusal from duty under specific qualifications and conditions. With an efficient setup to receive these requests either in writing or via email, the form emphasizes accessibility and ease of communication between the court and the public. Key aspects include mandatory juror disqualifications such as having a felony conviction without restored civil rights, currently being under prosecution, not residing in Escambia County, or not being a U.S. citizen. It also outlines valid grounds for requesting excusal - recent jury service, expecting mothers, seniors over the age of 70, those who care for dependents unable to care for themselves, full-time law enforcement officers or investigators, and parents of young children not employed full time. The form requires jurors seeking excusal for these or any other reasons to attest to their claims under penalty of perjury, ensuring the integrity of the process. This comprehensive approach reflects the judiciary's commitment to balancing civic duty with individual circumstances, making the legal system more accessible and sensitive to the needs of the community it serves.

QuestionAnswer
Form NameEscambia County Jury Excusal Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesjuryduty escambiaclerk com, clerk forms jury, jury duty escambia county, escambia county jury excusal

Form Preview Example

Pam Childers

Clerk of the Circuit Court and Comptroller, Escambia County

Clerk of Courts • County Comptroller • Clerk of the Board of County Commissioners • Recorder • Auditor

 

 

 

 

 

 

 

 

 

 

 

JUROR EXCUSAL REQUEST

Name:

 

 

 

Juror Number:

 

 

Address:

 

 

Report Date:

 

 

INSTRUCTIONS:

This completed request form for excusal must be received five business days prior to your report date in writing or by e-mail. Email completed form to juryduty@escambiaclerk.com.

To check your status visit http://www.escambiaclerk.com/jury/JurySummonsViewStatus.asp

MANDATORY JUROR DISQUALIFICATIONS (F.S. 40.013)

I am a convicted felon and have not had my civil rights restored.

I am currently under prosecution for a crime.

I do not live in Escambia County, Florida

I am not a citizen of the United States of America.

REQUEST FOR EXCUSALS (F.S. 40.013)

I have been summoned and reported as a prospective juror within the last 12 months. I am an expectant mother.

I am 70 years of age or older. Excuse me from this summons date only.

I am 70 years of age or older. Excuse me permanently (signature required below). I take care of a person who is mentally or physically unable to care for themselves. I am a full time federal, state or local law enforcement officer or investigator.

I am a parent not employed full time, and have custody of a child less than 6 years of age.

I REQUEST TO BE EXCUSED FROM JURY DUTY BECAUSE (briefly describe reason):

Under penalty of perjury, I request to be excused or am disqualified from jury duty for one of the reasons marked above. The above statements are true to the best of my knowledge.

Juror Signature (required)

Date

Phone Number (required)

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