Panola County, TX · Panola County
Statement for Permanent Age Exemption
Panola County residents over age 75 use this statement to request a permanent exemption from jury service.
At a glance
- Issued by
- City of Panola County · Panola County, Panola County, Texas
- Notarization
- Not required: file this form without a notary.
- Official source
- co.panola.tx.us
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This statement lets a Panola County resident over age 75 claim a permanent exemption from jury service. The applicant provides their name, juror number, address, birth date, and signature, and declares that the information is true and correct. Return the completed statement to the Panola County District Clerk by mail, email, or fax.
Who needs it
A Panola County resident over age 75 who wants to claim a permanent exemption from jury service should complete this statement.
How to submit it
Return the statement to the Panola County District Clerk at 110 S. Sycamore, Ste. 227, Carthage, Texas 75633, by email at [email protected], or by fax at (903) 693-6914.
About notarization
This statement is signed without a notary; the applicant declares the information is true and correct and signs and dates it.
How to submit this form
- 1
Download the Statement
Download the Statement for Permanent Age Exemption.
- 2
Complete the Applicant Details
Fill in your name, juror number, address, and birth date, then sign and date the statement.
- 3
Review Your Declaration
Confirm the information is true and correct, as stated on the form.
- 4
Submit to the District Clerk
Return the statement to the clerk’s office by mail, email, or fax using the contact details on the form.
Frequently asked questions
- Who can use the Statement for Permanent Age Exemption?
- A Panola County resident over age 75 may use the statement to claim a permanent exemption from jury service.
- What information does the statement request?
- It asks for the applicant’s name, juror number, address, birth date, and signature. The applicant also declares that the information is true and correct.
- Do I need a notary for the Statement for Permanent Age Exemption?
- No. The statement has no notary block; the applicant declares the information is true and correct and signs and dates it.
- How do I submit the Statement for Permanent Age Exemption?
- Return it to the Panola County District Clerk at the courthouse address on the form, or send it by email to [email protected] or by fax to (903) 693-6914.