Juror Hardship Request Form
Prospective Jurors:  The law limits the grounds upon which the jury commissioner may excuse jurors from service based on a personal hardship.    Prospective Juror asking to be excused from service due to a personal hardship must fill out and submit the form below.  You will be advised of the court's decision after 5:00 PM the evening prior to your scheduled jury duty, when you call the designated number, or check the status in the on-line system as described in your summons.
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Prospective Juror Name (last name,  first name) *
Juror Identification Number *
Juror PIN *
Date of Scheduled Jury Service *
Category of Hardship (check all that apply) *
Describe the circumstances that qualify you for the above-selected hardship excuse: *
Juror Sworn Declaration:   I declare under penalty of perjury that the above information is true.  (Type your full name to so declare) *
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