[COURT NAME AND ADDRESS]
I have received your letter of [DATE] summoning me to jury duty on [DATES].
Although I am honored by the privilege, I respectfully request that I be excused
from jury duty.
[STATE REASON(S): for example … ]
My employer will be unable to pay me during my absence for jury duty. This will
severely affect my financial position. If necessary, I can provide a statement from
Please understand my position and excuse me from jury duty at this time. You may
contact me at [PHONE NUMBER] if there are any concerns.
[YOUR NAME, ADDRESS AND PHONE NUMBER]