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TWO SIDED DOCUMENT IN THE SUPERIOR AND STATE COURT OF OCONEE COUNTY, STATE OF GEORGIA AFFIDAVIT FOR EXCUSAL OR DEFERRAL Personally appeared before the undersigned officer duly authorized to administer oaths, came who on oath says, I have been summoned for jury service to report and hereby request to be excused from this summons by the Judge or deferred by the Clerk of Court from jury service due to the following: I am a full-time student at a college, university, vocational school, or other post secondary school who is enrolled and taking classes or exams on the dates indicated in my jury summons. Juror shall provide proof of enrollment and school calendar. I am the primary care giver having active care and custody of a child six years of age or younger and have no reasonably available alternative child care. I am the primary, unpaid care giver for a person over six years of age with such physical or cognitive limitations that he or she is unable to care for him/herself and cannot be left unattended and there is not reasonably available alternative care. Juror shall provide a statement of a physician or other medical provider supporting the affidavit. I am a primary teacher of a Home School Program. Juror shall provide proof of home study program and school calendar. I am a Legislator and will be in attendance in the Legislature. I am an active member of the US Armed Forces or spouse of such service member on ordered military duty which requires me to be at least 50 miles from home. Juror shall present copy of valid military identification. I have a temporary medical condition that would prevent attendance on the dates for which presence is required for service. Juror shall provide a statement from a physician stating such fact. I will be engaged during this term of jury duty in work necessary to the public health, safety or good order or can show other good cause. Juror shall provide a statement substantiating the facts (Specify): Other (Specify): This day of 20 Juror Phone # Sworn to and subscribed before me this day of Notary Public/Clerk of Superior Court (Seal) Notary term ---PAGE BREAK--- TWO SIDED DOCUMENT IN THE SUPERIOR AND STATE COURT OF OCONEE COUNTY, STATE OF GEORGIA AFFIDAVIT FOR INACTIVATION Personally appeared before the undersigned officer duly authorized to administer oaths, came who on oath says, I have been having been summoned for jury duty to report and hereby requests to be marked as inactive on the county master jury list by the Board of Jury Commissioners due to the following reason: I am more than 70 years old, my date of birth being I have a permanent medical condition that prevents attendance for jury service (must have statement of permanent condition from physician) I am a noncitizen of the United States. I am no longer a resident of Oconee County (must show proof). I have not attained the age of 18 years, my date of birth being I have been convicted of a felony and have not had my civil rights restored. I have been declared mentally incompetent by a Court. Juror is deceased. This day of Juror Sworn to and subscribed before me this day of Notary Public/Clerk of Superior Court (Seal) Notary term expires ORDER Having considered the above affidavit, the Petitioner shall be: Excused from jury service. Deferred from jury service until the next term. Only one deferment shall be granted. Petitioner must report for service on Required to report as summoned. SO ORDERED, this day of Judge, Superior Court Western Judicial Circuit Or Clerk of Superior Court Oconee County