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J-2, r. 2 - Order number 1890 of the Minister of Justice and Attorney General concerning the Application for exemption or disqualification from jury duty or for postponement of jury duty to a later session

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SCHEDULE
Name of prospective juror: __________
Prospective juror number: __________
APPLICATION FOR EXEMPTION OR DISQUALIFICATION FROM JURY DUTY OR FOR POSTPONEMENT OF JURY DUTY TO A LATER SESSION
I, the undersigned, apply for
⃞ disqualification from jury duty;
⃞ exemption from jury duty; or
⃞ postponement of jury duty to a later session
on the following grounds (specify the reasons for the disqualification, exemption or postponement)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
_________________________________________
Date
_________________________________________
Place
_________________________________________
SIGNATURE OF THE PROSPECTIVE JUROR
All the facts alleged in the application are true.
IMPORTANT NOTICE
 
THIS APPLICATION MAY BE MADE BY ANY APPROPRIATE MEANS WITHIN 20 DAYS OF RECEIVING THIS SUMMONS. PLEASE ATTACH ANY NECESSARY SUPPORTING DOCUMENTS SUCH AS A DETAILED MEDICAL CERTIFICATE OR A BIRTH CERTIFICATE.
M.O. 1890; I.N. 2016-01-01 (NCCP); M.O. 2021-06-27.
SCHEDULE
Jury list number: __________ Given name(s) and surname of prospective juror:
Prospective juror number: __________ ________________________________________
APPLICATION FOR EXEMPTION OR DISQUALIFICATION FROM JURY DUTY OR FOR POSTPONEMENT OF JURY DUTY TO A LATER SESSION
I, the undersigned, having been duly sworn, apply for
□ disqualification from jury duty;
□ exemption from jury duty during the current session; or
□ postponement of jury duty to a later session
on the following grounds (specify the reasons for the disqualification, exemption or postponement)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
_________________________________________ ________________________________________
Date SIGNATURE OF THE PROSPECTIVE JUROR


□ Sworn _____________________________________
| IMPORTANT NOTICE |
| |
| THIS APPLICATION MUST BE MADE BY |
| REGISTERED MAIL |
At____(city or town), on ____(date of oath) | WITHIN 20 DAYS OF RECEIVING THIS |
| SUMMONS. PLEASE ATTACH ANY |
_________________________________________ | NECESSARY SUPPORTING DOCUMENTS |
Name and qualification of person | SUCH AS A DETAILED MEDICAL |
authorized to administer oaths | CERTIFICATE OR A BIRTH CERTIFICATE. |
|_____________________________________|
M.O. 1890; I.N. 2016-01-01 (NCCP).
SCHEDULE
Jury list number: __________ Given name(s) and surname of prospective juror:
Prospective juror number: __________ ________________________________________
APPLICATION FOR EXEMPTION OR DISQUALIFICATION FROM JURY DUTY OR FOR POSTPONEMENT OF JURY DUTY TO A LATER SESSION
I, the undersigned, having been duly sworn, apply for
□ disqualification from jury duty;
□ exemption from jury duty during the current session; or
□ postponement of jury duty to a later session
on the following grounds (specify the reasons for the disqualification, exemption or postponement)
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
_________________________________________ ________________________________________
Date SIGNATURE OF THE PROSPECTIVE JUROR


□ Sworn _____________________________________
| IMPORTANT NOTICE |
| |
| THIS APPLICATION MUST BE MADE BY |
| CERTIFIED OR REGISTERED MAIL |
At____(city or town), on ____(date of oath) | WITHIN 20 DAYS OF RECEIVING THIS |
| SUMMONS. PLEASE ATTACH ANY |
_________________________________________ | NECESSARY SUPPORTING DOCUMENTS |
Name and qualification of person | SUCH AS A DETAILED MEDICAL |
authorized to administer oaths | CERTIFICATE OR A BIRTH CERTIFICATE. |
|_____________________________________|
M.O. 1890.
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