Forms Samples Letters Excuse Jury Duty REQUEST TO BE EXCUSED

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					           REQUEST TO BE EXCUSED FROM OR POSTPONE JURY DUTY
                       FOR NON-MEDICAL REASONS

Any request to be excused or postpone jury duty must be received by the jury clerk no later than 10 working
days before your reporting date. The request may be faxed to 772-462-2124 or mailed to Clerk of Court, 218
South 2nd Street, Fort Pierce, FL 34950 (allow sufficient time for mailing). There is a different request form if
you are asking to be excused or seeking postponement for a medical reason.

IF YOU ARE NOT ADVISED BY THE JURY CLERK THAT YOU ARE EXCUSED OR POSTPONED,
YOU MUST APPEAR FOR JURY DUTY AS SCHEDULED (CALL 772-462-6983)

Under penalty of perjury, I request to be excused from jury duty for the following reasons:
Excuses Granted by Statute:
   Expectant Mother                                                                                         Not a United States Citizen
   Person 70 years of age or older                                                                          Currently being prosecuted for a crime
   Parent not employed full time, with child under 6                                                        Convicted felon, civil rights not restored
   years of age                                                                                             Sole caregiver of a person physically or mentally
   Active full-time law enforcement officer                                                                 handicapped and not paid for caring services
   Served as a juror in St. Lucie County within the                                                         No longer reside in St. Lucie County, my new
   last 12 months                                                                                           address is:____________________________
Non-Statutory Excuses:
   Do not read or understand the English language
   High school student                                                                                              Other:___________________________
   College or vocational student attending school in                                                        ________________________________________
   another county                                                                                           ________________________________________
   Traveling or working out of state for more than 6                                                        ______
   months                                                                                                   (Attach additional pages and appropriate
                                                                                                            documentation if necessary)


I request to have my jury duty postponed until _____________________ (within 6 months)
because I got my summons late, I have a family/business matter I must attend to on the date I am to
appear, I will be out of town on the date I am to appear, ____________________________________
You may request to postpone jury duty for up to 6 months. Indicate what month you will be available for jury
duty within the next 6 months. You may call 772-462-6983 to get upcoming dates for jury duty. You may not
request postponement of jury duty more than twice.
                                                                                          Clerk’s Use Only
NOTICE OF CHANGE OF ADDRESS                                                          G _______ D ______
My new mailing address:       _________________________________________              Rsch _____________
                               _________________________________________                                                                                              Judge _____________
                             _________________________________________ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _,_________________________________________ (zip )   Date ______________


JUROR SIGNATURE: ______________________________ Reporting Date for Jury Duty: _____________

Juror Name (Print): __________________________Juror Number:_________ Phone:_________
Jury Duty is an important civic duty, and failure to respond to the jury summons may be deemed as contempt
of court and punished as such.
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