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2. JUROR RESPONSE TO SUMMONS
4. Excusal
   Jury Excusal Form

   If you would like to request an excusal or postponement then please click "Jury Excusal Form" above to be redirected.

   
   

6. Please select which City you are summoned for:*

   1. Puyallup Municipal Court
   2. Milton Municipal Court
8. First Name*
9. M.I.
10. Last Name*
12. Per RCW 2.36.070, I am competent to serve as juror, as I am;*

    1. 1. (18) Eighteen years or older
    2. 2. A United States Citizen
    3. 3. A resident of the City or live within Zip Code served by the City
    4. 4. Am able to communicate in the English Language
    5. 5. I have never been convicted of a felony; or have had civil rights legally restored
14. I am qualified to serve as a juror*

    1. Yes
    2. No
16. IF NO, please explain:
18. DECLARATION OF JUROR QUALIFICATION*

    1. Yes, I hereby declare, under penalty of perjury of the laws of the State of Washington, that I have reviewed the above JUROR QUALIFICATIONS and am qualified to serve.
    2. No, I hereby declare, under penalty of perjury of the laws of the State of Washington, that I have reviewed the above JUROR QUALIFICATIONS and am NOT qualified to serve and have noted my reason above.
20. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
22. Electronic Signature*
23. Date*
    Date
25. Email Address*
26. Phone Number*
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit Submit and Print

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