Request for Jury Service Excuse or Deferral Form

Excuses will be granted ONLY for reasons of compelling personal hardship. Requests for excuses and postponements for jury duty must be made by electronically using the requested form below, or by mail or fax. Your request CANNOT be handled by telephone.

Until you have received a response from the District Court Judge’s Office / Clerk of Superior Court’s Office, you are still required to appear at the county courthouse for jury duty on the specified summons date if your juror number is called. If you DO NOT receive a response to an excusal request, you are still required to appear for jury service if your juror number is called.

Requirements and Instructions to Use the Electronic Submission Form for Excusal

NOTE: Only Alamance, Beaufort, Bladen, Brunswick, Burke, Cabarrus, Caldwell, Catawba, Chatham, Clay, Cleveland, Columbus, Cumberland, Durham, Forsyth, Graham, Henderson, Johnston, Lincoln, McDowell, Montgomery, Moore, Orange, Pasquotank, Pitt, Polk, Randolph, Robeson, Rockingham, Rowan, Rutherford, Sampson, Stanly, Swain, Transylvania, Tyrrell, Union, Vance, Wake, and Watauga Counties are currently available for this form. For other counties, please see your summons or contact your courthouse for information.

You must have the following three (3) items and/or capabilities to use the electronic submission form for jury excusal:

A valid and active email address.
Supporting documentation of your excuse in accordance with the policy of the county where you are summoned to appear (i.e., copy of your driver's license to show proof of residency change or a doctor's note) must be clear and easily readable. Select your county below or see your county jury service page for the policy on required supporting documentation. Only one document per request can be uploaded.
A device capable of producing or creating an electronic version of your provided supporting documentation (Acceptable file types include: jpg, jpeg, gif, png, pdf, or docx). Most cell phones or mobile devices will produce a jpg/jpeg files. If you take a picture of your supporting documentation with a cell phone or mobile device, you must know how to access it. If you use another device, such as a scanner, you must know how to access the file on your computer. Your proof must be attached to the appropriate request type and reason for your request. All proof must be in the upright position when uploaded. Once the upload begins, DO NOT interfere with or stop the process. No files should exceed 5 MB in size.

Attaching the wrong image, misspelled names, or other typographical errors will result in the denial of your excusal request and you will be required to appear in court on your assigned date and time.

The District Court Judge’s Office / Clerk of Superior Court’s Office and the County Sheriff’s Office are unable to answer questions regarding the three requirements for electronic submission of your request.

Statement of Agreement
By submitting the following Electronic Submission Form you are requesting to be disqualified or excused from jury service or to postpone/defer your jury service date. You understand that:

All requests must be submitted in accordance with the policy of the county where you are summoned to appear (e.g., minimum of ___ days prior to your jury service date.) Select your county below or see your county jury service page for the county policy.
An automated confirmation email will be sent to the email account specified in your excusal request to confirm receipt of your request.
It is your responsibility to monitor for a CONFIRMATION response from the District Court Judge’s Office / Clerk of Superior Court’s Office to determine if your request has been approved or denied.
If you do not receive a response indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to accurately enter all information. Improperly spelling your name or entering the incorrect file number will result in the immediate denial of your request.
Only one attachment per request can be uploaded. Before submitting the online form, please confirm that the electronic document attached is clear, readable, legible, and in the upright position.
Your request might not be granted.
Court / Clerk staff are unable to change any information once it has been submitted. It is your responsibility to ensure all information is correct and accurate before submitting your request.
All fields with a “*” are required.
Any submission with missing or incorrect required information will be denied.

Your Information

Last Name

First Name

Address

County

Select the county in which you have been summoned to appear. ONLY Alamance, Beaufort, Bladen, Brunswick, Burke, Cabarrus, Caldwell, Catawba, Chatham, Clay, Cleveland, Columbus, Cumberland, Durham, Forsyth, Graham, Henderson, Johnston, Lincoln, McDowell, Montgomery, Moore, Orange, Pasquotank, Pitt, Polk, Randolph, Robeson, Rockingham, Rowan, Rutherford, Sampson, Stanly, Swain, Transylvania, Tyrrell, Union, Vance, Wake, and Watauga Counties are currently available for this form. For other counties, please see your summons or contact your courthouse for information.

ALAMANCE COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by mail or email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your mail and email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

BEAUFORT COUNTY

All requests must be submitted a minimum of six (6) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

BLADEN COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

BRUNSWICK COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

BURKE COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive an email or phone call indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or phone for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

CABARRUS COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

CALDWELL COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email or phone call indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

CATAWBA COUNTY

All requests must be submitted a minimum of five (5) days prior to your jury service date.
If you do not receive a letter by mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

CHATHAM COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email or mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

CLAY COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email or mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

CLEVELAND COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter via mail or email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
You should monitor your mail and email for a CONFIRMATION letter from the Trial Court Administrator’s Office to determine if your request has been approved or denied.

COLUMBUS COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

CUMBERLAND COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

DURHAM COUNTY

All requests must be submitted a minimum of 14 days prior to your jury service date.
If you do not receive a letter by mail or email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your mail and email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

FORSYTH COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a response by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION response from the District Court Judge’s Office to determine if your request has been approved or denied.

GRAHAM COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email or mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

HENDERSON COUNTY

All requests must be submitted a minimum of five (5) days prior to your jury service date.
If you do not receive a letter by email or mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email and mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

JOHNSTON COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter via mail or email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
You should monitor your mail and email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

LINCOLN COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter via mail or email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
You should monitor your mail and email for a CONFIRMATION letter from the Trial Court Administrator’s Office to determine if your request has been approved or denied.

MCDOWELL COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

MONTGOMERY COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

MOORE COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

Required Documentation: The following is required to be submitted with your request for excusal / deferment:

If you are not a U.S. Citizen, please provide a copy of your visa or green card.
If you are not a resident of this county, please provide a copy of your driver's license.
If you are a full-time student at an out-of-state institution, please provide a copy of your schedule.
If you have a disability that interferes with jury service, please provide a doctor's statement.
If you are on a military assignment, please provide a copy of your orders.
Please explain your reason if you are aged 72 or older and wish to claim an exemption for a good cause.

ORANGE COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email or mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

PASQUOTANK COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email or mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

PITT COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

POLK COUNTY

All requests must be received by the date shown on your summons.
Until you receive a letter stating the judge’s decision regarding your request, you are still required to comply with the instructions as indicated on your jury summons and appear for jury service.
It is your responsibility to monitor your mail for a letter stating the judge’s decision regarding your request.

RANDOLPH COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

ROBESON COUNTY

All requests must be submitted a minimum of fourteen (14) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

ROCKINGHAM COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

ROWAN COUNTY

All requests must be submitted a minimum of five (5) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

RUTHERFORD COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

SAMPSON COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

STANLY COUNTY

All requests must be submitted a minimum of five (5) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

SWAIN COUNTY

All requests must be submitted a minimum of five (5) days prior to your jury service date.
If you do not receive a letter by email or mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email or mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

TRANSYLVANIA COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

TYRRELL COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

UNION COUNTY

All requests must be submitted a minimum of ten (10) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

VANCE COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter by mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your mail for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

WAKE COUNTY

All requests must be submitted a minimum of seven (7) days prior to your jury service date.
If you do not receive a letter in the mail indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your mail for a CONFIRMATION letter from the District Court Judge’s Office to determine if your request has been approved or denied.

WATAUGA COUNTY

All requests must be submitted a minimum of five (5) days prior to your jury service date.
If you do not receive a letter by email indicating the status of your request at least 24 hours prior to your assigned jury date, you must comply with all the instructions indicated on your jury summons.
It is your responsibility to monitor your email for a CONFIRMATION letter from the Clerk of Superior Court’s Office to determine if your request has been approved or denied.

Phone Number and *Provider (*Durham only)

Date of Jury Service

File Number / Badge Number (ex. 0-123456, located on your summons)

Badge Number (ex. 123456, see your summons)

Juror Number

Excuse Request Type (I declare under penalty of perjury the following:)

Other Excuse

Enter grounds or additional reason for excusal

Supporting Documentation

You may attach any supplemental documentation required for your request under this section.

If you are a full-time out of state student, a juror who is 72 years or older, or an individual who has a disability that could interfere with your ability to serve as a juror and wish to be excused, deferred, or exempted, please submit a signed statement of the ground of the request pursuant to G.S. 9-6.1 by attaching the signed statement under this section.

One file only.
5 MB limit.
Allowed types: jpg, gif, png, pdf, doc, docx.

Additional Comments

Failure to Appear Acknowledgement

I acknowledge that jurors who fail to appear as directed, or who fail to complete jury services until duly discharged are subject to a $50.00 fine (per N.C.G.S. 9-13) as well as potentially subject to the contempt powers of the court.

Confirmation

I have read, understand, and followed the above instructions. By submitting this request I affirm that I have provided proof for my request for a jury service change. I understand the penalties for providing or submitting false or inaccurate information.

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