You may submit this form electronically, by fax, or by U.S. mail.
A reasonable effort will be made to notify you if your request has been approved or denied. However, if you do not receive written or telephonic communication from this office, you must report on the assigned date.
 
MANDATORY EXEMPTIONS:
Under Florida Statutes, you may not serve on a jury if you check any of the following:
Persons under prosecution for any crime except minor traffic infractions.
Convicted Felon - Civil rights not restored.
Served as a juror in this county within the year immediately preceding the date of this summons.
Served as a juror in this county within the year immediately preceding the date of this summons.
No longer reside in Seminole County, please update the following:
NEW ADDRESS:
Not a citizen of the United States.
 
OPTIONAL EXEMPTIONS:
You have the option of being excused if you check any of the following:
70 years of age or older, wish to be temporarily excused.
70 years of age or older, wish to be permanently excused.
Parent, not employed full time, with custody of child under the age of six.
Expectant mother.
Person with physical or medical impairment
(please provide an explanation below).
Responsible for the care of someone who is mentally or physically incapable of caring for himself/herself (please proide an explanation below).
Active full time law enforcement officer (or auxiliary) or such entities of investigative personnel.
Department: ID #:
 
REQUEST FOR EXCUSAL/POSTPONEMENT:
Any request for excusal or postponement must be received at least ten (10) days prior to your report date.
I wish to be excused from jury service due to the following extreme hardship (occupational or business reasons are not valid for excusal):
(100 words or less)
I wish to have my jury service postponed at this time due to the following reason (valid reasons for postponement include, but are not limited to, occupational or business reasons, planned vacations, school attendance or temporary illness). Only one postponement per notice is allowed: