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Juror Excusal Form

  1. Jury Administration
    110 N Apopka Avenue
    Inverness, FL 34450

  2. Jury Summons Sample

    Image Depicts a Jury Summons.

  3. Disqualification:

    (Does not apply if you were granted excusal/rescheduled by the Judge.)

  4. Excusal:

    If your excusal is that you are physically sick or disabled, you must submit a doctor's certificate by fax to 352-341-6413, by email or by mail to the address listed. Failure to provide will result in denial of your request.

  5. By submitting this form you are electronically signing this document.

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  7. This field is not part of the form submission.