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AFFIDAVIT FOR EXEMPTION FROM JURY DUTY ACTIVE MILITARY EXEMPTION GEORGIA, COUNTY JUROR NAME JUROR ADDRESS I hereby affirm that I am currently on active duty with the United States Military and am currently stationed at and I request to be deferred from jury duty during the period of time that I am on active duty. I further affirm that my military duty will be completed on or about This day of Signature Print Name Phone No. Subscribe and sworn before me This ____day of Notary Public