Juror Excusal Form

If your request is not included in the list below, then your request must be addressed by the Judge. Please submit your request (and summons) by mail to:

Jury Administration
110 N. Apopka Ave.
Inverness, FL 34450

Enter your Juror Pool number, Juror ID number and Date Summoned as it appears on your summons. Check the applicable reason for disqualification or excusal then click on the SEND button.

Your Juror pool number and ID are located on the bottom right hand corner of your summons next to the bar code.


All fields marked with an * are required.
(Please use the format: MM/DD/YY)

I am under prosecution for a crime.
I am a convicted felon whose civil rights have not been restored.
I am the Governor, Lieutenant Governor, a Cabinet officer, a Clerk of Court, or a Judge.
I am not a U.S. Citizen.
I do not reside in Citrus County, Florida.
I am exempt from jury service because I was summoned and I reported for jury duty within one (1) year from the reporting date listed on this summons.
(Does not apply if you were granted excusal/rescheduled by the Judge.)

I am over 70 years old and request excusal from this date only.
I am over 70 years old and request permanent exemption from jury duty.
I am an expectant mother.
I am a parent who is not employed full time and have custody of a child under 6 years of age.
I am a full-time law enforcement officer or investigator.
I am responsible for the care of someone mentally or physically unable to care for himself or herself.
I am physically sick or disabled. (You must submit a doctor's certificate by fax to 352-341-6413, by email to JuryExcusals@clerk.citrus.fl.us or by mail to the address listed above. Failure to provide will result in denial of your request.)
I am a practicing attorney or physician.
Other

Request for excusal must be submitted at least 48 hours prior to your expected reporting date.

By submitting this form you are electronically signing this document.