Response to jury summons Please enable JavaScript in your browser to complete this form.Indicate your status to be able to attend jury serviceYour status to be able to attend jury service * I am coming to jury service I can't do jury service Your legal duty is to do jury service. You can also apply to be excused, but only for special reasons. Please choose 1 of the options aboveYour current informationProvide us your up to date information in so we are able to contact you.Full name: *FirstLastDate of birth: *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Daytime Contact Number *Email address: *EmailConfirm EmailYour jury summons detailsThis information should be clearly marked on your summons to juror letter.Juror Number: *Jury Service Date *>> I am coming to jury serviceThank you. You are helping your community. Please complete this section so we can compensate you your juror fees.Bank:Make SelectionANZBCIBSPCheque PaymentAccount Number:Account name - Pay cheque to:>> I can't do jury serviceYou can be excused from jury service for special reasons. Please complete this section to best indicate your circumstance.becauseI am aged 65 or over.My health or disabilityA special or pressing commitment for my business or jobMy family commitmentsI am a practicing member of a religion that says jury service is agains its beliefsMy job makes me ineligible to be on a juryOther personal circumstances - explain reason .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. File Upload/Attachment *Select to be excused on this occasion or permanentlyI want to be excused on this occasionI want to be excused permanentlySubmit Response