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Jury Postponement Form

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
Please provide the following information as it appears on your jury summons.
Fields marked with a single asterisk (*) are required to be completed. Fields marked with a double asterisk (**) one or more must be completed.
Please submit your request for postponement as soon as possible prior to your reporting date.
*Last name:
*First name:
*Report Date mm/dd/yyyy
*Judge's Name
*Juror ID Number
**Home Telephone
**Business Telephone
**Email Address
 

Postponement of Service

If you need to reschedule jury service indicate in the space provided below any Monday date within 6 months of your original summons. For example, if you were originally summoned to appear for jury service in the month of June you cannot request a postponement date any later than the last week in December. ONLY ONE POSTPONEMENT IS ALLOWED, THEREFORE PLEASE SELECT A DATE THAT WILL BE THE MOST CONVENIENT FOR YOU.
 
I WISH TO RESCHEDULE MY JURY SERVICE TO THE DATE OF:
You will receive a reply ONLY if your request for postponement is denied.
Comments (100 words or less)

 
By clicking the Submit Entry button, you are acknowledging that the above statements are true to the best of your knowlege and belief.

Jury Excusal/Disqualification Form

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
Please provide the following information as it appears on your jury summons.
Fields marked with a single asterisk (*) are required to be completed.
Fields marked with a double asterisk (**) one or more must be completed.
Please complete other areas as needed.
Please submit your request for excusal as soon as possible prior to your reporting date.
*Last name:
*First name:
*Report Date mm/dd/yyyy
*Judge's Name
*Juror ID Number
**Home Telephone
**Business Telephone
**Email Address
 

Mandatory Exemptions

You cannot serve if you qualify for any of the mandatory exemptions. Please indicate if you are:
Convicted of a felony, civil rights not restored
No longer reside in Pasco County, my new address is:
Not a U.S. citizen or legal resident of Florida
Served as a juror in Pasco County within 1 year.
        Date served:
Under prosecution for any crime
 

Optional Exemptions

A citizen is NOT automatically disqualified from jury service for the reasons listed below. If you qualify for any reason listed below, check the reason that is applicable. You will receive a reply only if you are not excused.
Expectant mother
Full time law enforcement officer/investigative officer
Full time student attending school at: NAME OF SCHOOL
       
I wish to be excused for medical reasons - MUST SUBMIT DOCTOR'S STATEMENT WITH ORIGINAL SUMMONS BY MAIL
You are a parent not employed full time with custody of a child under age 6
Person 70 years of age or over. Date of birth is:
      One time exemption    Permanent exemption
I am responsible for the care of someone who is incapable of caring for
       himself/herself.
If none of the above apply to your circumstance, YOUR EXCUSE MUST BE APPROVED BY A JUDGE. PLEASE EXPLAIN THE REASON YOU ARE REQUESTING TO BE EXCUSED (100 words or less).
You will receive a reply ONLY if you are NOT excused.
EXCUSALS - Deceased, Military, Other
I wish an excusal for the following reason(s):

 
By clicking the Submit Entry button, you are acknowledging that the above statements are true to the best of your knowlege and belief.