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Affidavit for Exemption

  1. Instructions
    You may claim a statutory exemption by completing the following online jury affidavit and clicking submit. By submitting the form below, you are certifying that the information submitted is true and correct.

    For additional options on how to claim an exemption or additional questions pertaining to this summons, contact the court at 817-952-2151.
  2. I do solemnly swear that I am exempt from jury service for the reason indicated below:
  3. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  4. Please enter your full name.
  5. Leave This Blank:

  6. This field is not part of the form submission.