Sugar Land, TX · Fort Bend County
Request for Exemption from Jury Service for Physical or Mental Impairment
This form lets a person request exemption from Sugar Land Municipal Court jury service because of a physical or mental impairment.
What this form is
Use this request to ask Sugar Land Municipal Court for a permanent or temporary exemption from jury service because of a physical or mental impairment. The form asks for the applicant’s contact and driver’s license information, juror number, requested exemption period, reason for the request, and physician’s contact information. A physician’s statement must be attached, and the applicant signs a declaration under penalty of perjury.
Who needs it
A person seeking a permanent or temporary exemption from Sugar Land Municipal Court jury service because of a physical or mental impairment needs this form.
How to submit it
Return the completed request to Sugar Land Municipal Court by mail at P. O. Box 110, Sugar Land, Texas 77487-0110, or by fax to 281-275-2648.
About notarization
This request is signed and dated without a notary; attach a physician’s statement, which the form does not say must be notarized.
How to submit this form
- 1
Download The Request
Download the Sugar Land Municipal Court request for exemption from jury service for physical or mental impairment.
- 2
Complete The Form
Print legibly in black ink and provide the requested applicant, juror, exemption, and physician information.
- 3
Attach The Physician’s Statement
Include the physician’s statement required by the form.
- 4
Sign And Date
Sign and date the declaration under penalty and perjury.
- 5
Return The Request
Mail it to Sugar Land Municipal Court or fax it to 281-275-2648.
Frequently asked questions
- Who can use this jury service exemption request?
- A person requesting a permanent or temporary exemption from Sugar Land Municipal Court jury service because of a physical or mental impairment can use this form.
- What must I attach to the request?
- The form requires an attached physician’s statement. It also asks for the physician’s name, telephone number, and address.
- Do I need a notary for this jury service exemption request?
- No. The request has no notary block and is signed and dated by the applicant. A physician’s statement must be attached, but the form does not say it must be notarized.
- How do I submit the jury service exemption request?
- Return it to Sugar Land Municipal Court by mail at P. O. Box 110, Sugar Land, Texas 77487-0110, or fax it to 281-275-2648.
Need something notarized?
This Request for Exemption from Jury Service for Physical or Mental Impairment doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.