Waiver of Juror Fees

Indicate below if you wish to be paid a fee of $10.00 per day plus mileage* for each day of jury service or if you are voluntarily waiving payment or if your employer requires you to waive payment.

 Employers are not required to pay you while you are on jury duty. Some employers continue to pay your wages while you serve, some do not. Of those employers who do pay your wages while you serve, some require that you waive your jury pay. This form is your authorization to waive that jury service payment. Check wtih your employer if you are unsure of your employer's pay policy.

Juror Number: