State statute
Lassen — Request for Excuse from Jury Service - Age
California foreclosure, tax-defaulted, court-ordered and probate-sale law and official procedures — verbatim and citable.
- Edition
- 2026-09-26
- Last updated
- 2026-09-27
- Jurisdiction
- Lassen County
Lassen — Request for Excuse from Jury Service - Age¶
Page 1¶
SUPERIOR COURT OF CALIFORNIA, COUNTY OF LASSEN 2610 Riverside Drive, Susanville, CA 96130
REQUEST FOR EXCUSE FROM JURY SERVICE – AGE
For Juror or Prospective Juror: ___________________________ Phone Number: ( ) - Name [Required] [Required]
Address: ____________________________________________________________________________________ [Required] Street City State Zip
Reason for Excuse Request: ☐ I am over 70 years of age. Date of Birth: _______________ [Required] Please Note: If you are over 70 years of age, it is not necessary to list other factors such as medical issues, care of a spouse, vacation, etc. You ONLY need to submit your request based on your age.
Additional Information (optional):
If you are seeking an excuse from a current summons, you will need to either attach your summons to this form or fill in this section using the information located under the barcode on the front of the summons you received.
Bar Code Number: _____________________ Date of Jury Service: __________________ Group #: _______
The Jury Commissioner may contact you to confirm the information provided.
I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct: SIGN
Signature Printed Name Date
Signature, Printed Name, and Date are required for your request to be considered.
Return this completed form in person or by mail on or before the date you are required to appear for jury service to:
Lassen Superior Court Attn: Jury Commissioner 2610 Riverside Drive Susanville, CA 96130
The Jury Commissioner’s office can be reached at 530-251-8228 if you have any questions. If the call is not answered, please leave a message and your call will be returned as soon as possible.
Form Adopted for Optional Use REQUEST FOR EXCUSE FROM JURY DUTY – AGE Cal Rules of Court, rule 2.1008 Lassen Superior Court LSC-JUR-101 [New April 12, 2022] www.Lassen.Courts.ca.gov