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Juror Absence Request Form
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Dear Judge of the Circuit Court for the City of Salem,
I am requesting that you excuse me from serving as a juror for the following dates and reasons(s).
I am requesting that you excuse me from serving as a juror for the entire term for the following reason(s).
How would you like to be notified?
Post Office Mail
Both Email and Post Office Mail
Electronic Signature (Please type your First and Last Name)
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