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The document lists selectable eligibility reasons, including pregnancy, specific parent-custody situations, recent prospective juror summons, age-related exemptions, caregiving responsibilities, law enforcement employment, hearing impairment without service desire, felon status without restored civil rights, pending criminal prosecution, relocation out of St. Johns County, and professional exemptions for attorneys and medical doctors. 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You will be notified shortly of the status of your request.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What kinds of reasons can be selected for excusal?",{"text":113,"@type":109},"The form allows selection of reasons such as pregnancy, certain parent/custody situations, age 70 or older, caregiving incapacity, full-time law enforcement employment, and professional exemptions for attorneys or medical doctors.",{"name":115,"@type":106,"acceptedAnswer":116},"What information is required to complete the attestation and submission?",{"text":117,"@type":109},"You must attest that the stated reasons are true and correct under penalty of perjury, provide signature, date, printed name, jury service date, candidate ID, phone number, and email address, then scan/email, fax, or mail the form.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},280937,1790578683,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":40,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":73,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},2336478945519,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","REQUEST FOR EXCUSAL OR DEFERRAL FROM JURY DUTY  \nNote: Submission of this request does not automatically excuse or defer you from jury duty. You will be notified shortly of the status of your request.  \n(Please check all that apply and print legibly)  \n☐ I seek excusal because I am an expectant mother.  \n☐ I seek excusal because I am a parent who is not employed full time, and I have custody of a child under 6 years of age.  \n☐ I seek excusal because I was summoned and reported as a prospective juror in this county within the past 12 months. Provide month and year of prior summons and report:    \n☐ I seek excusal because I am 70 years of age or older.  \nMy date ofbirth is:    \n☐ I seek excusal because I am responsible for the care of another who because of mental or physical incapacity is incapable of caring for himself/herself. Please specify:    \n☐ I seek excusal because I am employed as a full-time federal, state or local law enforcement officer. Please identify the law enforcement agency and your position:    \n☐ I seek excusal because I am deaf or hearing-impaired and understand I could serve if I desire in which case reasonable accommodations would be made forme; however, I do not wish to serve.  \n☐ I am not qualified to serve because I am a convicted felon whose civil rights are not restored. Please identify charge(s) for which you were convicted; court location; and approximate date of conviction(s) :  \n______________________________________________________  \n☐ I am not qualified to serve because I am currently under prosecution for a crime. Please identify the location of the pending criminal charges:  \n____________________________________________________________  \n☐ I am not qualified to serve because I no longer residing in St Johns County.  \nMy current residential address is:  \n_____________________________________  \n☐ I seek excusal because I am a practicing attorney and I wish to be excused. My Florida Bar number is:    \n☐ I seek excusal because I am a practicing medical doctor or doctor of osteopathic medicine and I wish to be excused. My license number is:  \n___________________  \n☐ I seek excusal because I am between the ages of 18 and 21 and I am a fulltime high school, college or career center student. Please state date of birth and school attending:    \n☐ I seek excusal because I am a woman who has given birth to a child within the past 6 months.  \n☐ I seek   excusal   postponement because of significant hardship, extreme inconvenience, physical infirmity, or public necessity (please explain):  \n_____________________________________________________________  \n_____________________________________________________________  \n_____________________________________________________________  \nI do hereby attest, subject to penalty of perjury, that the reason(s) stated above are true and correct.1  \nSignature Date Candidate ID  \nPrinted Name Date of Jury Service Phone Number  \nEmail Address  \nPlease scan and email to: [jury@stjohnsclerk.com](jury@stjohnsclerk.com) ; fax to (904)819-3666;  \nor mail to 4010 Lewis Speedway St. Augustine, FL 32084.   \n(This portion to be completed by reviewing judge only)  \n☐ Deny ☐ Excuse ☐ Defer ☐ Disqualified  \nNotes:   \nReviewing Judge Date  \n1 Pursuant to Florida Statutes, chapter 837, perjury is a criminal offense punishable by imprisonment and/or fine.","cbCaibXqmByGBzZb","https://ap.wps.com/l/cbCaibXqmByGBzZb","pdf",181309,"English","# Request for Excusal or Deferral from Jury Duty\n## Eligibility Reasons (Select All That Apply)\n## Candidate Attestation and Contact Information\n## Submission and Judge Review Section","[{\"question\":\"Does submitting this request automatically excuse or defer jury duty?\",\"answer\":\"No. Submission does not automatically excuse or defer you. You will be notified shortly of the status of your request.\"},{\"question\":\"What kinds of reasons can be selected for excusal?\",\"answer\":\"The form allows selection of reasons such as pregnancy, certain parent/custody situations, age 70 or older, caregiving incapacity, full-time law enforcement employment, and professional exemptions for attorneys or medical doctors.\"},{\"question\":\"What information is required to complete the attestation and submission?\",\"answer\":\"You must attest that the stated reasons are true and correct under penalty of perjury, provide signature, date, printed name, jury service date, candidate ID, phone number, and email address, then scan/email, fax, or mail the form.\"}]","Jury Duty Excusal or Deferral Request Form | PDF",1789562833]