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Engaging in jury duty is a fundamental aspect of civic responsibility in many countries, including the legal system. The Application for Exemption or Excusal from Jury Service form is a crucial document for those seeking exemption or excusal from this duty for various reasons. Initially, applicants are counseled to thoroughly review the form alongside the "Guide to Jury Service Eligibility and Applying for Excusal" to ensure a comprehensive understanding of the eligibility criteria and the process of application. Emphasis is placed on using a black pen and writing in block capitals for clarity, with clear instructions provided for correcting mistakes. The form requires detailed personal information to verify the applicant's identity and court details to process the request efficiently. It explores circumstances that disqualify or render an individual ineligible for jury service, such as age, residency criteria, convictions, and certain occupations or medical conditions. Moreover, it offers an opportunity to apply for excusal based on age, medical fitness, or other compelling reasons with a requirement to submit relevant proof. Finally, it underscores the significance of honesty in the application process, with a declaration that the information provided is accurate, demonstrating the seriousness with which the courts treat the jury service duty and the process for excusal or exemption.

Preview - Application For Exemption Or Excusal From Jury Service Form

Application for Exemption or

Excusal from Jury Service

If you wish to apply for exemption or excusal from jury service, please read this form and the “Guide to Jury Service Eligibility and Applying for Excusal” carefully before completing it.

Please use a black pen only, and write in BLOCK CAPITALS

.

Tick boxes as appropriate. If you make a mistake/tick the wrong box, shade in the box, initial it, and mark the correct box.

On completion please return this to:

Location (from the front of your citation)

Send to

 

 

If you have been cited to the SHERIFF COURT

The court address on the front of your citation

 

 

If you have been cited to the HIGH COURT in

Justiciary Office, Parliament House, Parliament Square,

EDINBURGH

Edinburgh EH1 2NT

 

 

If you have been cited to the HIGH COURT in

The Sheriff Clerk’s Office, Glasgow Sheriff and JP Court, 1

GLASGOW

Carlton Place, Glasgow G5 9DA

 

 

If you have been cited to the HIGH COURT

The court address on the front of your citation

anywhere else

 

Part 1 – About you

Please Note: You must fill in this section carefully or the court will not be able to find your records. Your application for excusal or exemption can only be considered if this section is completed.

1. Name

 

 

 

2. Address

Date of Birth:

 

 

 

Email address:

 

 

 

 

 

 

 

3. Personal ID Number:

 

 

 

4. Citation Number:

(This can be found on the front of your citation form)

(This can be found on the front of your citation form)

 

 

 

 

 

 

 

5. Court citied to:

 

 

 

6. Date citied to attend:

(See the front of your citation)

 

 

 

 

 

 

 

High Court

 

 

Sheriff Court

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(This is on the front of your citation form)

(tick the appropriate box)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7.Please provide any daytime telephone numbers where we can contact you between 9.00am and 5.00pm. This is solely so that we can contact you quickly with any further information. It will not be used for any other purpose.

Are any of the details you have provided different to those on your jury citation? If so, please provide the details that appear on your jury citation below.

Full Name:

Please enter all your names

Address:

Postcode

email:

Part 2 – Persons not qualified or ineligible for jury service

Please read boxes A and B in the “Guide to Jury Service Eligibility and Applying for Excusal” before completing this section. If you are not qualified or are ineligible for jury service please complete boxes below as appropriate.

I am below the age of 18

I am

 

years of age and my date of birth is

 

Now go to part 4

I have not lived in the United Kingdom, the Channel Islands or Isle of Man for any period of at least 5 years, since I was 13 years old

Now go to part 4

Please read the list in box A in the “Guide to Jury Service Eligibility and Applying for Excusal” before completing this section.

I have been convicted of an offence and sentenced to one of the disposals mentioned in box A of the guide, and am not a rehabilitated person in terms of the Rehabilitation of Offenders Act 1974.

Please specify below the sentence, date of sentence and sentencing court:

and/or

I am on bail in or in connection with criminal proceedings in any part of the United Kingdom.

Please specify below the date and place (police station/court) you were granted bail:

Now go to part 4

Please read the list in box B in the “Guide to Jury Service Eligibility and Applying for Excusal” before completing this section.

I am ineligible for jury service due to my occupation.

I am employed as (please specify below)

I am receiving medical treatment for mental disorder as described in box B.

The precise category which applies to me is: ( please specify below)

Now go to part 4

Part 3 – Application for excusal from jury service

Please read the information in boxes C, D and E in the “Guide to Jury Service Eligibility and Applying for Excusal” before completing the boxes below, as appropriate, if you wish to apply for excusal.

I wish to apply for excusal from jury service:

as one of the categories in box C in the Guide to Jury Service Eligibility and Applying for Excusal applies to me.

(Please read the guidance document carefully, in the majority of cases excusal as of right would need to be requested within 7 days of receipt of the citation for jury service). The precise category which applies to me is:

I am aged 71 or over and I would like to apply for excusal as of right.

I am aged 71 or over and I would like to apply for permanent excusal

Other reason (specify below)

Other reason (where appropriate)

My date of birth is

Please note: it is an offence to falsely claim excusal as of right

as I am medically unfit for jury service and I enclose a medical certificate from my doctor.

My doctor considers my condition is long term/unlikely to change and this information is included in my medical certificate.

Now go to part 4

as I am away from home on a holiday or on business at the time I am required for jury service and I enclose evidence of this (e.g. copy of hotel confirmation, travel confirmation).

Now go to part 4

due to the following special reason:

(Please note: you must enclose any evidence supporting this reason in order that your application can be considered appropriately).

Now go to part 4

Please note: Should you be excused from jury service on this occasion, a further jury citation shall be sent to you within 12 months unless you have been permanently excused.

Part 4 – Declaration

Before completing this section, please make sure that you have read this form and the “Guide to Jury Service Eligibility and Applying for Excusal” carefully.

I declare that the foregoing information is correct and acknowledge that I may be asked for proof of any statement made above.

Signed

Date

FOR OFFICIAL USE ONLY

Ineligible?

 

Yes

 

 

 

Date:

 

 

 

NoExcusal:

Granted

 

Refused

 

 

 

SCS013 V3.5 February 2019

Form Data

Fact Detail
Form Use This form is used to apply for exemption or excusal from jury service.
Writing Requirement Applicants must use a black pen and write in BLOCK CAPITALS.
Correction Procedure If a mistake is made, the incorrect box should be shaded, initialed, and the correct box marked.
Submission Addresses Depending on the court cited to, the form is returned to either the address on the front of the citation, the Sheriff Court, or the High Court in Edinburgh or Glasgow.
Part 1 Requirement Personal details must be completed accurately for the application to be considered.
Ineligibility Conditions Age under 18, not having lived in the UK, Channel Islands, or Isle of Man for 5 years since age 13, certain convictions, being on bail, or certain occupations and medical conditions relating to mental disorder.
Excusal Categories Excusal categories include being over the age of 71, having a medical condition verified by a doctor, and being away from home for business or holiday.
Excusal Evidence Requirement Evidence must be submitted to support an application for excusal based on specific reasons.
Declaration and Official Use The declaration confirms the information is correct, with a section for official use regarding eligibility and excusal decisions.

Instructions on Utilizing Application For Exemption Or Excusal From Jury Service

When it comes time to respond to a jury service citation, filling out the Application for Exemption or Excusal from Jury Service form is a critical step for those seeking exemption or excusal. This document is designed to guide individuals through the eligibility criteria and the application process, ensuring that all necessary information is accurately conveyed to the court. Careful attention to detail and adherence to the instructions will ensure that the application is considered without unnecessary delays.

To successfully complete the form, follow these steps:

  1. Firstly, ensure you have the “Guide to Jury Service Eligibility and Applying for Excusal” at hand. This guide contains vital information that will help you fill out the form accurately.
  2. Use a black pen and write in BLOCK CAPITALS throughout the form to ensure legibility.
  3. Tick boxes that apply to your situation. If a mistake is made, fully shade in the incorrect box, initial it, and then mark the correct box.
  4. Part 1 – About you: Fill in your personal details thoroughly, including:
    • Your full name.
    • Address, date of birth, and email address.
    • Personal ID number and Citation number (found on the front of your citation).
    • Specify the court cited to and the date cited to attend.
    • Provide any daytime telephone numbers for contact between 9.00am and 5.00pm.
    If your current details differ from those on your jury citation, provide the citation details in the space provided.
  5. Part 2 – Persons not qualified or ineligible for jury service: Refer to boxes A and B in the guide. Tick the appropriate boxes if you are below 18, have not lived in the UK for at least 5 years since age 13, have certain criminal convictions, are on bail, or are ineligible due to occupation or medical treatment for mental disorder. Specify any required details.
  6. Part 3 – Application for excusal from jury service: After reading boxes C, D, and E in the guide, tick the relevant reason(s) for applying for excusal. This can include age criteria, medical unfitness supported by a medical certificate, or being away from home. Again, specify all necessary details and attach any required evidence.
  7. Part 4 – Declaration: Confirm that the information provided is correct and acknowledge the declaration with your signature and the current date.
  8. Finally, return the completed form to the appropriate address based on where you have been cited. The return address varies depending on whether you've been cited to the Sheriff Court or High Court and its location, as detailed on the front of your citation.

Diligence in completing this form not only aids in the swift processing of your application but also ensures that you meet your obligations in responding to a jury service citation. Remember, accuracy and completeness are key to potentially being excused from jury service.

Obtain Answers on Application For Exemption Or Excusal From Jury Service

  1. How do I apply for exemption or excusal from jury service?

    To apply for exemption or excusal from jury service, you need to fill out the 'Application for Exemption or Excusal from Jury Service' form. Start by reading both the form and the 'Guide to Jury Service Eligibility and Applying for Excusal' carefully to understand the criteria and process. Use a black pen, write in BLOCK CAPITALS, and tick the appropriate boxes. If a mistake occurs, shade in the wrong box, initial it, and then mark the correct one. Once completed, the form should be sent to the location indicated on the front of your jury citation. Make sure all personal details match those on your citation to avoid issues with record matching.

  2. What should I do if my details differ from those on the jury citation?

    If any details you provide on the form are different from the information on your jury citation, it is crucial to specify the citation's details at the designated section. This step is essential for ensuring that the court can accurately identify you and process your application without any confusion or delays. Enter your full name, address, postcode, and email as they appear on the citation.

  3. Who is not qualified or eligible for jury service?

    Before completing the application, it's important to know who isn't qualified or eligible for jury service:

    • Individuals under the age of 18.
    • Those who haven't lived in the United Kingdom, the Channel Islands, or Isle of Man for a period of at least 5 years since turning 13.
    • People convicted of certain offences or not considered rehabilitated under the Rehabilitation of Offenders Act 1974.
    • Individuals currently on bail in connection with criminal proceedings anywhere in the United Kingdom.
    If any of these conditions apply, you should fill in the corresponding sections in Part 2 of the form and then proceed directly to Part 4 for declaration.

  4. Can I be excused from jury service due to a holiday or business trip?

    Yes, being away from home for a holiday or on a business trip at the time you are required for jury service is considered a valid reason for excusal. In the application for excusal section of the form, specify this reason and attach evidence such as hotel confirmation or travel confirmation. It's essential to provide this evidence to ensure your application can be properly considered. Please note that if your request is granted, you might still receive a new jury citation within the next 12 months unless you've been permanently excused.

Common mistakes

Filling out the Application For Exemption Or Excusal From Jury Service form seems straightforward, but mistakes can easily slip through. Here's a list of common errors that applicants should avoid to ensure their application is processed without delay:

  1. Not using block capitals and a black pen as specified, which can make the application hard to read and possibly delay processing.

  2. Overlooking the need to tick boxes appropriately. If a mistake is made, failing to properly shade in the incorrect box, initial it, and then tick the correct box can confuse the reviewers.

  3. Skipping the “About you” section or not filling it out with care. Since the court uses this information to find your records, incomplete information might mean your application can’t be acted upon at all.

  4. Entering incorrect details or differences in information between the application and the jury citation without clarification. Any discrepancy here can lead to unnecessary delays or the application being overlooked.

  5. Failing to read the eligibility guide properly before marking exemptions or exclusions based on age, residency, criminal convictions, bail conditions, mental disorder treatments, or ineligible occupations. This mistake can invalidate your application for exemption or excusal.

  6. Forgetting to specify required details such as the type of court the citation is for (e.g., HIGH COURT in Edinburgh or Glasgow), which is crucial for directing the application to the correct court location.

  7. Omitting contact information, which hampers the court's ability to reach out quickly for any further information, could stall the application process.

  8. Applying for excusal without including necessary evidence such as a medical certificate for health reasons, proof of prearranged travel, or other special reasons. Applications lacking supporting documents are often incomplete.

  9. Ignoring the guidance document sections C, D, and E when applying for excusal. Not understanding the categories fully or the conditions for automatic right to excusal can lead to incorrect applications.

  10. Failure to understand that if excused, a new jury citation might be sent within 12 months unless one has been permanently excused, leading to confusion and unpreparedness for future citations.

Each mistake can derail the process, causing delays or even the potential of having to serve regardless of valid reasons for exemption or excusal. It's essential to approach this document with attention to detail and complete vigilance to ensure a smooth application process.

Documents used along the form

When engaging with the judicial system, particularly in the process of jury duty, the Application for Exemption or Excusal from Jury Service form is a key document for those seeking release from this civic obligation under specific circumstances. However, this form often goes hand-in-hand with various other documents, both to support the application itself and to navigate other related judicial requirements or processes. Understanding these associated documents can streamline the application process and ensure compliance with judicial requests.

  • Guide to Jury Service Eligibility and Applying for Excusal: This guide accompanies the application form, providing detailed explanations of eligibility criteria for jury service, grounds for excusal, and the procedural steps to apply for an exemption or excusal. It is crucial for accurately completing the application form.
  • Medical Certificate: A formal document from a licensed healthcare provider detailing a person's medical condition and explaining why it prevents them from serving on a jury. It must be submitted if claiming medical unfitness as a reason for excusal.
  • Proof of Age Documentation: Valid identification showing the applicant's date of birth is required for those applying for excusal based on age, whether seeking excusal as of right (for those 71 and over in some jurisdictions) or seeking permanent excusal due to advanced age.
  • Proof of Travel: Documentation such as travel confirmation, hotel bookings, or an itinerary is needed when applying for excusal due to being away from home for vacation or business during the period of jury service.
  • Occupational Documentation: For individuals whose profession may exempt them from jury service, official documents or a letter from the employer specifying the nature of employment and the reason for excusal eligibility are required.
  • Court Notice or Citation: The official notification or summons to jury duty, which the applicant received, initiating the need to fill out an exemption or excusal application. This document provides the court’s details, the case for which jury service is required, and the scheduled date of service.
  • Legal Representation Letter: If applicable, a letter from a lawyer detailing any ongoing legal proceedings that may affect a person's eligibility for jury service, such as being on bail, which needs to be disclosed in the application for excusal.

Together, these documents form a comprehensive package that supports an individual's application for exemption or excusal from jury service. By providing clarity, evidence, and legal justification where necessary, they enable the court to make an informed decision regarding the applicant's request. It’s beneficial for individuals to understand the importance of each document and to prepare them thoroughly along with their application, ensuring that the process proceeds as smoothly as possible.

Similar forms

  • Voter Registration Form: Similar to the Application for Exemption or Excusal from Jury Service, the Voter Registration Form collects personal identification information such as name, address, and date of birth. Both forms serve civic duties and require accurate and clear personal data to process their respective applications.

  • Disability Parking Permit Application: This document is similar in the way it asks for personal details and requires proof of eligibility, much like the Jury Service application where medical unfitness needs to be supported by a medical certificate for the application to be considered.

  • Passport Application Form: Both forms require detailed personal information and supporting documents to verify identity. The Application for Exemption or Excusal from Jury Service and the Passport Application both use checkboxes and have sections that the applicant must fill out accurately to avoid processing delays.

  • Student Loan Deferment Request Form: This form, like the Application for Exemption or Excusal from Jury Service, includes sections on personal information and eligibility criteria. Applicants must provide reasons for their request, supported by evidence, much like excusing oneself from jury duty on grounds such as educational commitments.

  • Job Application Form: Requires personal information, contact details, and sometimes reasons for applying, similar to the personal ID and contact information sections in the jury service excusal form. Both forms initiate an important process based on the information provided by the applicant.

  • Change of Address Form for Government Documents: Like the jury service form, it requires current and accurate personal details for processing and has sections dedicated to personal identification numbers or similar identifiers. Both forms ensure that crucial documents or information are sent to the correct address.

  • Medical Information Release Form: This type of form shares similarities in its requirement for personal details and the need for consent through a declaration. In the Application for Exemption or Excusal from Jury Service, medical unfitness for jury duty must be documented and consent given to verify this claim, akin to releasing medical information under specified conditions.

Dos and Don'ts

When it comes to fulfilling your civic duty through jury service, understanding the process for applying for exemption or excusal is crucial. It’s important to approach this task with attention to detail and respect for the processes set by the court. Here are nine essential do's and don'ts when completing the Application for Exemption or Excusal from Jury Service form:

  • Do read the "Guide to Jury Service Eligibility and Applying for Excusal" thoroughly before you start filling out the form. This guide is designed to help you understand the eligibility criteria and how to properly apply for excusal or exemption.
  • Do use a black pen and write in BLOCK CAPITALS, as requested. This ensures your application is legible and processed efficiently.
  • Do tick boxes carefully as instructed. If you make an error, shade in the wrong box, initial it, and then tick the correct box. This method helps to avoid confusion about your intentions.
  • Do provide all the necessary information in Part 1 about yourself. Accurate and complete information is necessary for the court to identify your records and consider your application.
  • Do check your eligibility for jury service based on age, residency, criminal convictions, bail status, occupation, and mental health as outlined in Parts 2 and 3. Fill in these sections thoughtfully, as they play a critical role in determining your qualification for jury service.
  • Don't forget to provide any evidence or documents required to support your application for excusal, especially if you are applying based on medical unfitness or planned absence during the service period.
  • Don't neglect to sign and date the declaration in Part 4 of the form. Your signature is necessary to affirm that the information you have provided is correct and complete.
  • Don't overlook the instructions on where to send your completed form based on the court you have been cited to. Sending your application to the correct address ensures it reaches the appropriate office for processing.
  • Don't hesitate to provide details of any changes in your contact information that differ from those on your jury citation. Prompt communication of these changes aids the court in reaching you with further information or updates about your jury service.

By following these guidelines, you can navigate the exemption or excusal process with confidence, ensuring that your application is complete, accurate, and duly considered by the court.

Misconceptions

When it comes to fulfilling civic duties, jury service stands as a crucial pillar of the judiciary system, yet misconceptions about the Application for Exemption or Excusal from Jury Service form are widespread. The truth about this form can help citizens navigate their obligations with clarity and ease.

  • Only older adults can apply for excusal: Age is just one of the factors considered for excusal from jury service. Individuals under 71 can also apply for excusal based on various grounds such as medical issues, being away on holiday or business, or other special reasons detailed in the application form.

  • Completing the form guarantees excusal: Submitting an application does not ensure automatic excusal. The court reviews each application individually and makes a decision based on the provided information and relevant guidelines.

  • Any writing tool can be used to fill out the form: The form specifies the use of a black pen and that applicants must write in BLOCK CAPITALS. This requirement ensures readability and helps prevent errors in processing the application.

  • Medical excusal requires no proof: When applying for excusal based on medical reasons, a doctor's certificate stating the condition is necessary. This documentation supports the claim and is crucial for the application’s consideration.

  • Digital submission is an option: The form instructions indicate that the completed form should be returned to the specified court address. There is no provision for digital submission, underscoring the importance of sending the physical document to the court.

  • Any kind of mistake on the form leads to automatic rejection: If a mistake is made, such as ticking the wrong box, applicants are advised to shade in the box, initial it, and then mark the correct one. This procedure allows for adjustments without leading to automatic rejection.

  • Personal contact information is used for juror summoning: Daytime telephone numbers are requested solely for the purpose of conveying further information quickly if necessary. They are not used for summoning jurors or for any other unrelated matters.

  • All citizens qualify for jury service: Certain categories of people are not qualified or are ineligible for jury service, such as individuals below the age of 18, those who haven’t lived in the United Kingdom, the Channel Islands or Isle of Man for a certain period, and various professional or health-related exemptions.

  • Once excused, you will never have to serve: Those excused from jury service may still receive a citation within 12 months unless they have been permanently excused. Permanent excusal and temporary excusal are distinct, and the application form caters to both scenarios.

  • Applications for excusal are only accepted after receiving a citation: While it's true that the application process starts after receiving a citation, requests for excusal as of right, typically due to age, need to be made within 7 days after the receipt of the citation for certain categories as indicated in the guidelines.

Dispelling these misconceptions ensures that individuals are better prepared to fulfill their jury service duties, or apply for excusal or exemption accurately and effectively. Understanding the complexities of this civic responsibility is key to participating in the judiciary process confidently and responsibly.

Key takeaways

Filling out and using the Application For Exemption Or Excusal From Jury Service form requires attention to detail and understanding of eligibility criteria. Here are four key takeaways to ensure the process goes smoothly:

  • Read the provided guides carefully. Before you even start filling out the form, it’s crucial to thoroughly read the “Guide to Jury Service Eligibility and Applying for Excusal.” This guide contains essential information that can help you understand if you qualify for excusal or exemption from jury duty.
  • Use a black pen and BLOCK CAPITALS. To ensure your application is processed efficiently and without delay, fill out the form using a black pen and write in block capitals. This makes the application easier to read and process.
  • Tick boxes appropriately and correct mistakes properly. When ticking boxes to indicate your choices, do so carefully. If you make a mistake, shade in the box completely, initial it, and then tick the correct box. This method keeps the form tidy and minimizes confusion.
  • Provide accurate contact information. Part 1 of the form asks for your details, including a daytime telephone number. This information is crucial as it allows the court to contact you if they need more information or to provide updates on your application. Ensure that all information provided matches the details on your jury citation for a smoother process.

Remember, your application for excusal or exemption can only be considered if the form is completed accurately. Incorrect or incomplete applications may result in delays or the need to submit a new application. Always check that your application matches the details on your jury citation and provide any evidence required to support your request for excusal or exemption.

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