AO 223: Notice of Excuse

AO 223, Notice of Excuse, is a short notice from the Office of the Clerk of a United States District Court to a juror. It opens with "Dear Juror" and tells the juror what action the court will take with regard to the summons for jury service, and it is signed by the Clerk of the Court. The U.S. Courts page lists it under Jury Forms, effective on March 1, 1994, and the form is dated Rev. 3/94.

The U.S. Courts page says the form is primarily used by district courts to manage juries, and that people should contact the federal court that selected them for jury service or visit the Jury Service section for more information. It is a notice the court sends, not a form a juror files.

This page explains the form in plain words and is not legal advice. You can fill it out free in your browser on this page and download the result without an account.

Top of page 1 of AO 223: Notice of Excuse, as printed by COURTS

What's on AO 223

Mailer heading

United States District Court, Office of the Clerk, (See address on reverse side), with Official Business and Penalty for Private Use $300 in the corner.

Not required to report

Two choices: "You are not required to report for jury duty" and "Your request to be excused will be granted. You are not required to report for jury duty."

Temporarily excused

The juror is temporarily excused until a date, until further notice, or until notified in the future of the exact date to appear.

Request cannot be granted

"Your request to be excused cannot be granted. You are to report for jury service" on a date the court fills in, or as directed in the summons.

Signature and footer

The Clerk of the Court signature line, a Fold mark, and the footer AO 223 (Rev. 3/94) Notice of Excuse. The PDF page holds two copies of the notice with cut lines between them.

How AO 223 is filled out

1
Check one action
One of four boxes is checked: not required to report, request granted, temporarily excused, or request cannot be granted.
2
Fill in the dates
A temporary excuse runs until a date or until further notice, or says the juror will be notified of the exact date. A denied request gives a report date or says as directed in the summons.
3
Sign as Clerk of the Court
The notice is signed on the Clerk of the Court line.
4
Fold and mail
The notice prints a Fold mark and says to see the address on the reverse side. The downloaded PDF shows only the front of the notice.

The form is completed by the clerk's office, not by the juror.

Why fill Form AO 223 on indox

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Who sends it, fees and questions

Who sends it

The Office of the Clerk of a United States District Court sends it to the juror, signed by the Clerk of the Court.

Fees

The form does not print a fee. The $300 on the form is the mailer line Penalty for Private Use $300 next to Official Business.

Questions about jury service

The U.S. Courts page says to contact the federal court that selected you for jury service or visit the Jury Service section for more information about jury service.

Format and date

The U.S. Courts page offers AO 223 as a PDF, lists it under Jury Forms and shows it as effective on March 1, 1994.

Who uses AO 223?

The Clerk of the Court
The notice is headed Office of the Clerk, United States District Court, and the signature line reads Clerk of the Court.
District courts
The U.S. Courts page says this form is primarily used by district courts to manage juries.
Jurors who received a summons
The notice is addressed to a juror and tells them the action the court will take with regard to their summons for jury service.
Jurors who asked to be excused
Two of the choices answer a request to be excused: one says the request will be granted, and one says it cannot be granted and gives a date to report or points to the summons.

The form is a notice from the court to a juror. These are the people it names.

Official sources and the blank

Official U.S. Courts form page
The agency’s own page for Form AO 223.
Blank PDF
The official blank form, to print or fill by hand.

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Questions about Form AO 223

Do jurors fill out AO 223?

No. AO 223 is a notice from the Office of the Clerk, signed by the Clerk of the Court and addressed to the juror. The U.S. Courts page says it is primarily used by district courts to manage juries.

What does temporarily excused mean on the notice?

The form gives three choices under a temporary excuse: until a date, until further notice, or the juror will be notified in the future as to the exact date to appear.

What if the request to be excused is not granted?

One box says "Your request to be excused cannot be granted. You are to report for jury service" on a date the court fills in, or as directed in the summons.

Is the $300 on AO 223 a fee?

No. It is the mailer line Penalty for Private Use $300 printed next to Official Business. The form does not print a fee.

Who can answer questions about jury service?

The U.S. Courts page says to contact the federal court that selected you for jury service or visit the Jury Service section on its site.

AO 223: Notice of Excuse