Response to Jury Summons Court Address Please ensure The address is seen in the envelope window Jury service is a key part of the New Zealand justice system. By participating you make an important contribution to your community. Your time and commitment are greatly appreciated. Please complete this form to respond to your jury summons and return it to the court by email or by using the postage paid envelope included in your jury summons pack. Information to help you complete this form is included in the jury summons pack and on page 4 of this form. You are required to attend court on the date shown in your jury summons. In some situations you can apply to defer (put off) your jury service to another time or to be excused from attending (if excused you may or may not be summoned again in the future). Your options are described below to help you respond to your jury summons: I will attend on the date shown in my jury summons I will attend, but would like to put my jury service off to a later date (see page 4 section A) We also need you to tell us a period of time in the next 12 months that you are available to attend for jury service. Fill out page 2 Fill out pages 2 and 3 I can't attend for jury service because: • I'm applying to be excused (see page 4 section B) • I don't have to do jury service e.g. I'm over 65 (see page 4 section C) Fill out pages 2 and 3 • I'm not eligible to do jury service (see page 4 section D) OFFICE USE ONLY DECLINED DEFERRED ON HOLD EXCUSED – code ENTERED 1 / / Your contact details We need your correct contact details to pay your jury fees and reimburse you for travel or childcare costs. YOUR Current Details FAMILY NAME FIRST NAME(S) ADDRESS DATE OF BIRTH TELEPHONE EMAIL REF Number (This number is provided in your jury summons) Sign your response form Name I confirm that the information I have entered is correct. Signature Date D D (If sending by email you do not need to sign) /M M/ Y Y Y Y Claiming travel expenses If you are attending on the date shown in your summons, please complete the section below to help the court pay your travel costs: I will attend by public transport – It will cost $ I will be travelling by private motor vehicle – I will be claiming parking costs of $ My house is approximately per day (if known) km from the court If you cannot get to court by public transport or private motor vehicle please contact the court. NOTE: The court will not reimburse taxi costs unless you have prior approval to use a taxi from the court. If you are attending on the date shown in your summons you do not need to provide any more information. Thank you very much for your response and your commitment to jury service. 2 Your application If you want to apply to put off your jury service to another date or to not attend for jury service please tell us why below: NOTE: The court can only accept reasons that are allowed for in legislation. Your application must refer to one of these reasons (listed on page 4 of this form) and include supporting information. Examples of supporting information are also provided on page 4 of this form for your guidance. Preferred dates If you are applying to put off your jury service to another time please give us your preferred dates below: NOTE: You must give this information or your application will not be considered. The dates you give us must be for a period of time of at least four weeks. I am available from: D D / M M / Y Y Y Y (no earlier than 8 weeks from the date of your summons) until: D D / M M / Y Y Y Y (no later than 12 months from the date of your summons) Thank you very much for your response and your commitment to jury service. The court will advise you if your application has been granted within five working days of receiving this response form. 3 Reasons to put off or be excused from jury service A C Applying to defer (put off) service Sometimes you may have a reason for deferring your jury service. Please read the section Reasons for deferring or being excused from jury service (below). If one of these reasons applies and you cannot attend this time, the court may allow you to defer your jury service to a time in the next 12 months. The court registrar will consider your application and decide whether your service can be deferred. The registrar must be satisfied that attending jury service will cause undue hardship or serious inconvenience to you, another person, or the general public. B Other reasons for not serving as a juror You may not have to serve as a juror if you apply in writing and confirm that you: • are a practising member of a religious sect or order that is opposed to jury service • are 65 years of age or more • have attended or carried out jury service in the previous two years • have been excused from jury service for a period that has not yet expired. D Applying to be excused from jury service Some people cannot do jury service You cannot serve on a jury if any of the following circumstances apply to you: • some people with certain occupations cannot serve on a jury, e.g. employees of Department of Corrections (See section 8 of the Juries Act 1981 for a full list) Sometimes you may need to be excused from jury service. Please read the section Reasons for deferring or being excused from jury service (below). If one of these reasons applies to you and deferring your service is not practical on this occasion, the court may excuse you from attending. The court registrar will consider your application and decide whether you can be excused from jury service on this occasion. • people with intellectual disabilities cannot serve on a jury • people who: - have been sentenced to imprisonment for life or for a term of three years or more, or to preventive detention - have been sentenced to imprisonment for a term of three months or more, in the last five years. Reasons for deferring or being excused from jury service You may be able to defer or be excused from jury service because: • your occupation or business may need you to work because of special commitments • you have a physical disability • your health, family commitments, or other personal circumstances do not allow you to attend. Examples of useful information to support your application Occupation or business • Supporting letter from employer detailing why you can’t be released for jury service • Business card to confirm your employment type • Confirmation from employer of your employment type Health or disability • Medical certificate • Support letter from ACC or other agency • Letter from your caregiver • Photocopy of hospital or doctor’s appointment Family commitments • Letter from doctor advising you are a caregiver for a family member • Copy of birth certificate(s) of young children in your care Personal circumstances • Copy of university exam schedule • Holiday itinerary Age • Copy of birth certificate • Copy of driver’s licence Religion • Copy of printed information about your religion, sect or order Outside jury district (more than 45 kms) • A bill or bank statement sent to your current address (no details are required, feel free to tear away the financial or billing information) 4