Affidavit For Exemption From Jury Duty Inability To Comprehend English

AFFIDAVIT FOR EXEMPTION FROM JURY DUTY INABILITY TO COMPREHEND ENGLISH Government Code Section 62.109 allows for a permanent exemption from jury service based upon the inability to comprehend the English language. The exemption may only be granted by court order once an affidavit is received from the prospective juror. Please complete the affidavit and bring it to the District Clerk's Office for submission to the Court. You will be notified if your request is granted or denied. Applicant's Name: ___________________________________________ Juror No.: _____________________ Applicant's Full Address: ____________________________________________________________________ __________________________________________________________________________________________ Date of Birth: _____________________ Daytime phone: ___________________________________________ Evening Phone: ____________________________ email: __________________________________________ Applicant states "I am unable to comprehend or communicate in the English language. Interpreter ____________________________________, has translated the facts of this affidavit to the affiant in ___________________ ( language), and so verifies by signing below. _________________________________________________________________________________________ (Interpreter, friend or relative) PLEASE NOTE THE FOLLOWING 1. The affidavit must be sworn to by the affiant in person before the district clerk or a deputy district clerk at: Hays County District Clerk's Office, 712 S. Stagecoach Trail, Suite 2211, San Marcos, TX 78666 . (AS SHOWN ON EITHER VOTER REGISTRATION OR TEXAS DRIVER LICENSE) STATE OF TEXAS COUNTY OF HAYS "I _______________________________________, on my oath state the above and foregoing statements are within my knowledge true and correct." __________________________________________ Subscribed and sworn before me the undersigned this _________ day of ______________________________, 20 ______. ___________________________________________ Deputy Clerk Signature of Applicant or Applicant's Designee ORDER The above affidavit for exemption from jury duty was presented to the _________ District Court of Hays County, Texas. The Court orders that it should be granted denied as requested and that the applicant be exempted from jury duty in the justice, county and district courts of Hays County, Texas. Signed this ____________ day of _______________________________________________, 20______. ___________________________________________ Presiding Judge For Court Use Only Computer updated date: ____________________ Sent to Election Administrator: ____________________ Completed by: _____________________________ American LegalNet, Inc. www.FormsWorkFlow.com