If you request to be deferred or excused from jury service, you may be required to provide a statutory declaration before we are able to approve your request. If you have received a summons, you can find a statutory declaration on the back of your form. Otherwise, you can download one below.
What you need to do
What you need to do
If completing the statutory declaration found on the back of your summons:
Step 1
- Tick the first box and nominate a month you wish to be deferred to within the next 3 months; OR
- Tick the second box requesting to be excused from jury service, and also tick the appropriate box for the reason you are seeking to be excused
Step 2
- Write a brief paragraph detailing the reason you are applying to be deferred or excused from jury service, including any relevant information
Step 3
- Provide your primary contact number (landline or mobile) and email address
Step 4
- Do not complete this step until you are in the presence of an authorised witness
- Once in the presence of an authorised witness, you must sign and date the declaration
- The authorised witness will then sign, date, print their name and the address of where the signing took place, and list the authority under which they can witness declarations
The statutory declaration is now valid and legally binding.
What you need to do
If completing the statutory declaration downloaded from this website:
Step 1
- Provide your email, best contact number (landline or mobile), and juror number at the top of the form
Step 2
- In the appropriate spaces, print your full name, address, and occupation
Step 3
- In the space provided, nominate whether you are applying to be deferred or excused
- Write a brief paragraph detailing the reason you are applying to be deferred or excused from jury service, including any relevant information
Step 4
- Do not complete this step until you are in the presence of an authorised witness
- Once in the presence of an authorised witness, you must sign and date the declaration in the nominated space in the bottom-right of the form
- The authorised witness will then sign, date, and print the address of where the signing took place
The statutory declaration is now valid and legally binding.
What is a statutory declaration?
A statutory declaration is a written statement that you sign and declare to be true and correct in the presence of an authorised witness.
By signing it, you agree that the information in it is true and correct. You can be charged with a criminal offence if the information is false.
Who is an authorised witness?
An authorised witness is somebody who is authorised by legislation to witness statutory declarations.
Generally, the most convenient and common authorised witnesses are:
- Justice of the Peace
- Police officer
- Doctor
- Pharmacist
A full list of authorised witnesses, as well as further information on how to correctly complete a statutory declaration, can be found on the Department of Justice and Community Safety website (External link).
Download the statutory declaration form
Download the statutory declaration form, print it out, complete it, and submit it to Juries Victoria either through the online Juror Portal or via email.
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