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STATE OF TEXAS COUNTY OF MIDLAND within my knowledge true and correct. Signature of Applicant or Applicant s Designee Subscribed and sworn before me the undersigned this day of 20. Notary Public or Deputy Clerk ORDER The above affidavit for exemption from jury duty was presented to the District Court of Midland County Texas. AFFIDAVIT FOR EXEMPTION FROM JURY DUTY FOR PHYSICAL OR MENTAL IMPAIRMENT Government Code Section 62. Signed this day of 20. Presiding Judge PHYSICIANS STATEMENT FOR...
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