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IN THE SUPERIOR COURT BLAIRSVILLE, UNION COUNTY, GEORGIA AFFIDAVIT FOR EXEMPTION FROM JURY DUTY (CHILD CAREGIVER EXEMPTION) GEORGIA, UNION COUNTY JUROR JUROR I hereby affirm that I am the primary caregiver having active care and custody of a child six years of age or younger and that I have no reasonably available alternative child care and that I request to be excused or deferred from jury duty in accordance with O.C.G.A. 15-12-1-(a)(3). Child’s This of Print Phone Subscribe and sworn before me This of Notary Public