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Jury Summons Exemption or Disqualification Form

  1. CITY OF VICTORIA MUNICIPAL COURT

    Instructions: You must report for jury service unless you (1) claim an exemption; (2) are disqualified; or (3) choose to postpone your service.

    To claim an Exemption: Circle the exemption(s) that you claim. Submit this request electronically to the City of Victoria Municipal Court Clerk’s Office seven days before your schedule date of service. NOTE: You do not have to claim an exemption and may instead choose to serve.

    If you are Disqualified: Mark the qualification(s) that you do not meet. Submit this form electronically to the City of Victoria Municipal Court clerk’s office seven days before your schedule date of service. NOTE: If you claim to be disqualified because you are not a resident of this county, you may become ineligible to vote in this county. If you state that you are not a U.S. citizen, you will no longer be eligible to vote if you fail to provide proof of U.S. citizenship to your county voter registrar.

    To Postpone or be Excused from Service: Submit your request electronically to the City of Victoria Municipal Court Clerk’s Office seven days before your schedule date of service before your scheduled date of service.

    Questions or Special Accommodations: Please contact City of Victoria Municipal Court Clerk’s Office at (361) 485-3050 or courtclerk@victoriatx.gov

  2. QUALIFICATIONS FOR JURY SERVICE (select if you do NOT qualify)

    To serve as a juror you must meet the following qualifications:

  3. EXEMPTIONS FROM JURY SERVICE (select if you are Exempt)

    You may be excused from jury service if: (SELECT THE EXEMPTION YOU ARE CLAIMING):

  4. Please be detailed and upload any supporting documentation.

  5. Please be detailed and upload any supporting documentation.

  6. You must click the checkbox to indicated agreement*

  7. By submitting this form, you hereby swear and affirm that the information provided above is correct. *

    Upon review of your request, Municipal Court will send you notification regarding whether your request was approved or denied by the Judge.

    Please send notification by:

  8. Please upload your Driver's License, Identification card, or other proof of identification. This request is mandatory.

  9. Please contact the court.

    It is your responsibility to follow up with the court at 361-485-3050 or courtclerk@victoriatx.gov to verify receipt of your request.

  10. Right to Reemployment:

    A private employer may not terminate the employment of a permanent employee because the employee serves as a juror. An employee whose employment is terminated in violation of this section is entitled to return to the same employment that the employee held when summoned for jury service if the employee, as soon as practical after release from jury service, gives the employer actual notice that the employee intends to return. (Civil Practice and Remedies Code, Section 122.001).

  11. Failure to Answer Summons and Provision of False Information:

    A person who fails to comply with this summons, or who knowingly provides false information in a request for an exemption or to be excused from jury service, is subject to a contempt action punishable by a fine of not less than $100 nor more than $1,000 (Government Code, Section 62.0141). Additionally, a person shall be fined not less than $100 nor more than $500 if the person: (1) fails to attend court in obedience to this summons without reasonable excuse; or (2) files a false claim of exemption from jury service. (Government Code, Section 62.111; see also Code of Criminal Procedure, Article 35.01).

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