Fillable Form Ao 224 - Request For Excuse printable pdf download

Form Ao 224 - Request For Excuse

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NITED

TATES

ISTRICT

OURT

OFFICIAL BUSINESS

OFFICE OF THE CLERK

PENALTY FOR PRIVATE USE $300

)

(See address on reverse side

Dear Juror:

G We received a letter from

requesting that you be excused from jury service. Such requests must come from jurors

themselves. If you wish to be relieved of this responsibility write a letter to this office

requesting to be excused and setting forth your reasons. Your letter together with the letter

from the above individual will then be submitted to the court for consideration.

G In order to process your request for excuse from jury service we need a letter from

your Doctor telling us whether or not you will be able to serve in the future. Please

obtain such a letter and submit it promptly to this office.

Clerk of the Court

AO 224 (Rev. 3/94) Request for Excuse

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