Marin — JUR017

Source: https://www.marin.courts.ca.gov/system/files/forms-and-filing/jur017-marin-public-transit-reimbursement-form-1-25.pdf

Superior Court of California County of Marin PUBLIC TRANSIT JUROR REIMBURSEMENT FORM

NAME:

JUROR BADGE NUMBER:

RESIDENCE ADDRESS:

CITY, STATE, ZIP:

EMAIL ADDRESS:

TELEPHONE NUMBER:

Pursuant to CCP 215 jurors and prospective jurors who utilize public transit service to attend their juror service may submit a reimbursement request up to a daily maximum of $12 per day. DATE PUBLIC TRANSIT TYPE (bus/train) TOTAL COST OF ROUNDTRIP

$

$

$

$

$

$

$

CLAIM TOTAL: $

APPROVED REIMBURSEMENT TOTAL BY COURT: $

I HEREBY CERTIFY that the above statement is a true and correct statement of the public transit expense incurred by me while traveling for jury duty for the County Superior Court. CLAIMANT’S SIGNATURE Marin DATE

Form JUR017 Last updated: January 23, 2025