Juror Excuse Statement Form PDF Details

Being summoned for jury duty is a responsibility that embodies the essence of participating in the democratic process. However, there are circumstances where an individual might need to be excused from this duty, either due to automatic disqualification, personal exemption, or extreme hardship. The Juror Excuse Statement form serves as a critical tool for those who find themselves in such situations, enabling them to formally request an exemption or disqualification. Automatically disqualified individuals might include non-citizens, those adjudicated incompetent without restored rights, convicted felons without restored civil rights, residents of another county, or individuals currently under prosecution for a crime. Exemptions could be requested by expectant mothers, full-time law enforcement officers, parents with young children, caregivers of dependents incapable of self-care, seniors over the age of seventy, or those who have served as jurors within the last year. The form also accommodates individuals experiencing extreme hardships that would prevent them from serving. To be considered, the form must be completed, signed, and delivered through specified channels to the Clerk of the Circuit Court. This process not only underscores the importance of jury service in the justice system but also acknowledges the diverse circumstances of potential jurors, offering a structured mechanism to address their unique situations.

QuestionAnswer
Form NameJuror Excuse Statement Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namessarasota jury duty, jury scgovnet online, jury duty excuse letter, sarasota county jury office

Form Preview Example

JUROR EXCUSE STATEMENT

Instructions: If you are automatically excused by law or you are requesting to be excused from jury service, please complete this form. This statement must be signed and may be mailed to Karen E. Rushing, Clerk of the Circuit Court, Jury Services, P.O. Box 3079, Sarasota, FL 34230-3079; faxed to (941)-861-7738, or emailed to jurygroup@scgov.net. Unless you are contacted by the Court, your request for exemption under Section II or III has been granted. You must comply with the instructions and provide a telephone number.

Section I: Disqualification (Automatic Excuse)

I am not a citizen of the United States.

I have been adjudicated incompetent with my competency rights not restored.

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

I do not possess a valid Florida Driver’s license

or identification card or have not requested to serve as a juror by affidavit.

I do not reside in Sarasota County.

I am under prosecution for a crime.

Section II: Exemption (You may request to be excused)

I am an expectant mother.

I am a full time law enforcement officer, or among such entities’ investigative personnel.

I am a parent who is not employed full time, and have custody of a child under six years of age.

I am a person responsible for the care of another, incapable of caring for themselves.

I am 70 years of age or older, and wish to be permanently excused.

I am 70 years of age or older, and wish to be excused at this time.

I have served as a juror in Sarasota County within the last 365 days.

Section III: Extreme Hardship

Hardship Reason (state reason):

____________________________

Under penalties of Perjury, I declare that I have read the foregoing juror postponement or excuse form and swear or

affirm that the facts stated in it are true. (F.F. 92.525)

Juror Number: _____________________

Juror name: _________________________________________

Report Date: ______________________

Where to report: Sarasota

Venice

Signature (Required)

 

 

 

____________

 

Phone (Home)

 

(Work)

 

____________

 

 

 

 

 

 

 

 

 

 

 

 

 

JuryexcusestatementFeb2012

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