If you cannot serve on your summoned date, generally you may reschedule your jury service one (1) time within
90 days of the original date you are summoned. Complete the section below if you want to postpone your service.
Proof of circumstances must be submitted with your request, when available.
2) I AM NOT AVAILABLE AS SCHEDULED BECAUSE (Check One):
2a. I have an employment conflict.
2b. I am a full-time student who will lose credit if absent (May postpone until the next school break).
2c. I am a teacher who is in session (May postpone until the next school break).
2d. I have a prepaid travel plans within the next 30 days.
2e. I am a breastfeeding mother (May postpone for up to one (1) year).
2f. Other (please explain):
I am available after (required):
Note: If you are not able to report to jury service once summoned after a one (1) time postponement has been
granted, you must immediately contact the Court (see page 1 for contact information).
California Code of Civil Procedure section 204(b) states that eligible persons may be excused from jury service
only for undue hardship. Complete the section below if you believe you have an undue hardship and need to be
excused from jury service. Proof of circumstances must be submitted with your request, when available.
3) I AM REQUESTING TO BE EXCUSED DUE TO UNDUE HARDSHIP BECAUSE (Check One):
3a. I have no reasonable means of travel by public or private transportation and the total travel time to
get to the courthouse exceeds one and a half hours (1.5 hours).
3b. I am experiencing an extreme and intolerable personal financial hardship (see instructions below).
▪ If employed, you must submit a letter from your employer confirming you will lose all wages, salary,
or commission during your service.
▪ If self-employed, you must submit an explanation of how jury service causes a loss of income
and/or hinders the operation of the business and why the loss cannot be avoided by postponing jury
3c. I have a medical disability or scheduled operation/procedure (You must submit a statement from
your healthcare provider indicating you cannot serve on jury duty and the expected duration of disability).
3d. I am over the age of 70 and suffer from a permanent medical condition which would expose me to
an undue risk of physical or mental harm.
3e. My services are immediately needed for the protection for public health and safety and alternative
arrangements cannot be reasonably made (You must submit an explanation).
3f. I am the sole and indispensable caretaker for another person and comparable care is not
economically practical (You must submit verification of the need to provide care).
3g. I have served as a trial or grand juror in state of federal court within the past 12 months.
3h. I am actively serving in the military and stationed at (location)
until (date) (You must submit a copy of your military orders).
I declare under penalty of perjury under the laws of the State of California that the information I have
provided is true and correct.