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By statute, the following persons, and no others, may claim an exemption from jury service if the person wishes to do so. If you have a legal exemption, which you desire to claim, select the appropriate statement.
If you are seeking a student exemption, list the school you are attending.
Under Penalty of Perjury, I certify the above is true and correct. ( A signature is acquired by typing your name above).
This field is not part of the form submission.
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