Escambia County Jury Excusal Form PDF Details

When you are summoned for jury duty, the last thing you want to deal with is a long and complicated form. That's why the Escambia County Jury Excusal Form is designed to be easy to use. Simply follow the instructions on the form, and you will be able to quickly let the court know why you cannot serve on jury duty. The form can be submitted online or by mail, and it is available in English and Spanish.

In the list, there is some information relating to the escambia county jury excusal form. This figure will give you details about the form's length, finalization duration, and the areas you will be expected to fill.

Form NameEscambia County Jury Excusal Form
Form Length1 pages
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 Number:






Report Date:




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

To check your status visit


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.


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.


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)


Phone Number (required)

How to Edit Escambia County Jury Excusal Form Online for Free

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entering details in jury duty escambiaclerk com stage 1

Write the details in I have been summoned and reported, I REQUEST TO BE EXCUSED FROM JURY, Under penalty of perjury I request, Juror Signature required, Date, and Phone Number required.

Entering details in jury duty escambiaclerk com part 2

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