Alachua County Jury Excusal Form

Please provide the following information:

First Name:
Last Name:
Report Date:
(Example: MM/DD/YY)
Juror Number:
Home Telephone:
(Example: XXX-XXX-XXXX)
Business Telephone:
(Example: XXX-XXX-XXXX)
E-mail Address:


Under Florida Statutes 40.013, you may not serve on a jury if any of the following reasons apply.  Please indicate if you:


A citizen is not automatically disqualified from jury service for the reasons listed below, but may request to be exempted for any of the following:

A pregnant woman
Any person over 70 years of age
A person who has reported as a prospective juror for jury service in Alachua County within one (1) year from the prospective service month (federal jury service not included)
Cases of extreme hardship (please explain below)
A parent not employed full time, and having custody of a child under six (6) years of age
A care giver of a person with a mental or physical infirmity (please explain below - medical verification may be required)
A law enforcement officer (must have arresting powers)
An individual with significant physical or mental infirmity (please explain below)


Your request must be approved by the Court.  Please explain the reason you are requesting to be excused or postponed (100 words or less).

To inquire about the status of your postponement or excusal requests, you must contact the Jury Information line at (352) 337-6238. 
Please allow 24-48 hours for processing (excluding holidays and weekends).