Get the free Jury Duty Request Form - CORE Occupational Medicine
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JURY DUTY REQUEST FORM
To request pay and/or leave for Jury Duty, please review CORE's policy and complete
information below and submit to Human Resources for review and approval.
Policy
CORE will
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How to fill out jury duty request form
How to fill out jury duty request form
01
To fill out a jury duty request form, follow these steps:
1. Obtain the jury duty request form from the appropriate source, such as the court or website.
02
Read the instructions on the form carefully to understand the requirements and guidelines for completing it.
03
Start by providing your personal information, such as your full name, address, contact information, and any other details requested.
04
Fill in the date and location of the jury duty service you are requesting.
05
Answer any additional questions or sections on the form related to your eligibility, availability, or exemptions.
06
Sign and date the form to confirm the accuracy of the information provided.
07
Make a copy of the completed form for your records before submitting it.
08
Submit the form as instructed, either by mail, fax, online submission, or in person at the designated location.
09
Keep a copy of any confirmation or receipt provided after submission, in case it is needed for future reference.
10
Follow any further instructions provided by the court or jury duty office regarding next steps or communication.
Who needs jury duty request form?
01
Anyone who has received a jury duty summons or notice to appear may need to fill out a jury duty request form. Additionally, individuals who wish to request a postponement, deferment, or exemption from jury duty may also need to fill out this form.
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