I can’t do jury service
You are legally required to do jury service. You can apply to be excused from jury service if you are unable to put off
(defer) your jury service or are unable to perform juror duties.
Your application must refer to at least 1 of the reasons below (from the Juries Act 1981).
Tell us why you want to be excused from jury service
Tick 1 of the boxes below, explain your reasons below and attach proof of your situation.
I am over 65 (No explanation or supporting document is
needed).
If you are over 65 you can come to jury service or apply to
be excused on this occasion or permanently.
I want to be excused on this occasion
I want to be excused permanently
My health or disability (Explain your reason and attach
proof, like a medical certificate or a letter from ACC,
another agency or your caregiver).
If you have a severe health condition or disability you can
apply to be excused on this occasion or permanently.
I want to be excused on this occasion
I want to be excused permanently
A special or pressing commitment for my business
or job (Please explain your reason and attach proof, like
a letter from your employer saying why it would be very
hard for them if you did jury service or provide proof of the
nature of your business or a copy of a contract).
My family commitments (Please explain your reason
and attach proof, like a copy of a medical certificate of
copies of birth certificates of children in your care).
I live outside the jury district (Please explain if you live
more than 45 kilometres away from the court or outside of
New Zealand. Please attach proof like a copy of mail sent
to your current address. If you don’t live in NZ, update
your address on the electoral roll at elections.org.nz).
I am a practising member of a religion that says
jury service is against its beliefs (Explain your reason
below and attach proof, like an official letter from a
superior in your religious group).
I have done jury service in the last 2 years (No
explanation or proof is needed).
I have been excused from jury service for a period
that has not yet ended (Explain your reason below and
if possible attach proof, like a letter from the court).
In the last 5 years, I have been sentenced to
imprisonment or home detention for 3 months or
more (If you are on home detention, please give us a
letter from your Probation Officer. No explanation or proof
is needed if you have been imprisoned in the last 5 years).
I have been sentenced to imprisonment for 3 years
or more, or to preventive detention (No explanation or
proof is needed).
My job mades me ineligible to be on a jury (People in
certain jobs are not allowed to serve on a jury (section 8,
Juries Act 1981), like a job with the Department of
Corrections. Please explain your reasons below and
attach proof, like a business card or letter from a
manager).
Other personal circumstances (Please explain your
reason and attach proof to show why it would be very hard
for you to do jury service).
Reason (like ‘I am not able to do jury service because of a severe health condition. Copy of medical certificate
attached’). You can attach an extra page if needed.
Please sign and date the form
Signature Date
Send in your form
Complete, sign and print the form. Attach proof of your situation. You can post it to the District or High Court that summoned
you for jury service using the postage paid envelope included in your jury summons pack or scan and email the form. You will get a
letter from the court within 7 working days of the court getting this form.
If you need help please call 0800 268 787 or visit justice.govt.nz/jury-service.
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