AO 224: Request for Excuse

AO 224, Request for Excuse, is a short letter from the Office of the Clerk of a United States District Court to a juror. Despite its name, it is not a request the juror fills out: it opens with "Dear Juror", is signed by the Clerk of the Court, and asks the juror for a letter before an excuse from jury service can be considered. The U.S. Courts page lists it under Jury Forms, effective on March 1, 1994, and the form is dated Rev. 3/94.

The letter has two check boxes. One tells the juror the office received a letter from someone else asking that the juror be excused, and the other asks for a letter from the juror's doctor. The U.S. Courts page says the form is primarily used by district courts to manage juries.

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 224: Request for Excuse, as printed by COURTS

What's on AO 224

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.

Letter from someone else

"We received a letter from" a name the clerk fills in, "requesting that you be excused from jury service." The form says such requests must come from jurors themselves.

The juror's own letter

The first box goes on: a juror who wishes to be relieved of this responsibility may write a letter to the office asking to be excused and setting forth the reasons. Both letters are then submitted to the court for consideration.

Doctor's letter

"In order to process your request for excuse from jury service we need a letter from your Doctor telling us whether or not you will be able to serve in the future."

Signature and footer

The Clerk of the Court signature line, a Fold mark, and the footer AO 224 (Rev. 3/94) Request for Excuse. The PDF page holds two copies of the letter with cut lines between them.

How AO 224 is filled out

1
Check the box that applies
The clerk's office checks the box about a letter from someone else, the box asking for a doctor's letter, or both.
2
Name the letter writer
In the first box, the name of the person whose letter the office received goes on the blank line after "We received a letter from".
3
Sign and mail
The letter is signed on the Clerk of the Court line. It prints a Fold mark and says to see the address on the reverse side, which the downloaded PDF does not show.
4
What the juror sends back
The form asks for the juror's own letter setting forth the reasons, or a letter from the juror's doctor, which it asks the juror to obtain and submit promptly to the office.

The clerk's office completes the form. The juror answers it with a letter.

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Where letters go, fees and questions

Where the juror's letter goes

The form says to write to "this office", the Office of the Clerk, and says to see the address on the reverse side. The downloaded PDF shows only the front.

Who decides

The form says the juror's letter, together with the letter from the other person, will then be submitted to the court for consideration.

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.

Who uses AO 224?

The Clerk of the Court
The letter 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 someone else wrote about
The first box tells the juror the office received a letter from a named person asking that the juror be excused. The form says such requests must come from jurors themselves.
Jurors asked for a doctor's letter
The second box is about a juror's own request for excuse. It asks for a letter from the juror's doctor saying whether or not the juror will be able to serve in the future.

The form is a letter 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 224.
Blank PDF
The official blank form, to print or fill by hand.

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Questions about Form AO 224

Is AO 224 a form a juror fills out to ask for an excuse?

No. Despite its name, AO 224 is a letter from the Office of the Clerk to a juror, signed by the Clerk of the Court. It asks the juror for a letter. The U.S. Courts page says it is primarily used by district courts to manage juries.

Can someone else ask the court to excuse a juror?

The first box of the form tells the juror the office received a letter from another person and says such requests must come from jurors themselves. It says a juror who wishes to be relieved of this responsibility may write a letter to the office asking to be excused and setting forth the reasons.

What should the doctor's letter say?

The form asks for a letter from the juror's doctor telling the office whether or not the juror will be able to serve in the future, submitted promptly to the office.

Who decides whether a juror is excused?

The form says the juror's letter, together with the letter from the other person, will be submitted to the court for consideration.

Is the $300 on AO 224 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.

AO 224: Request for Excuse