You must call the number on your "Important Information Form" after 2:00PM on the day before the jury selection date appearing on your summons. A recorded message will let you know if you are required to attend jury selection.

Jury Summons Response Form

For assistance completing the following Jury Summons Response form, please refer to the following links:

Juror Summons Form - front of page
Juror Summons Form - back of page

An exemption may be applied for by EITHER
a) completing and returning the jury summons which was mailed to you to by the Clerk's Office or
b) using the form below.

Please do not submit the form both ways.

Full Name

Juror Number (9 digits)

Jury Selection Date:

Select Year

20242025

Select Month

Select Date

Report Time

8:15 AM8:30 AM9:00 AM1:00 PM

Jury Selection Location - Select Location (mandatory)

Is your current address different than what appears on the Jury Summons you received? If so, please update it here:

Date of Birth

Gender

Occupation

Employer

Phone Number (including area code)

Do you speak, understand, and read:

English
French
Both

Section A - Qualifications of Jurors

Please refer to Section A on the back of the Jury Summons.

Are you a resident of Alberta?

YesNo

Are you 18 years of age or older?

YesNo

Are you a Canadian citizen?

YesNo

Section B - Exclusion From Jury Service

Please refer to Section B on the back of the Jury Summons.

Are you asking to be excluded from jury service?

YesNo

Further Details

Section C - Exemption From Jury Service

Please refer to Section C on the back of the Jury Summons.

Are you asking to be exempted from service based on any of the following?

YesNo

If Yes

My conscience or religious vows preclude me from serving on a jury
I have served on a jury within 2 years preceding this summons (provide the date that you previously served as a juror in the details below)
Jury service will cause severe hardship in respect of my health or livelihood or in respect of any legal or moral obligations I may have to others (provide further details below)
I do not reside within a reasonable distance to where the court sittings are to be held (provide further details below)
I suffer from a physical, mental or other infirmity that is incompatible with the discharge of the duties of a juror (provide further details below)
I am not able to understand, speak or read the language in which the trial is to be conducted
My service on the jury would be contrary to the public interest because of my performance or urgent and essential services of public importance that cannot reasonably be rescheduled or performed by another during my absence (provide further details below)
I am 65 years of age or over

Further Details

By submitting this form, you certify that you are the person named in the Juror Summons, or you are authorized to respond on their behalf, and that the information submitted is true and correct to the best of your knowledge.

You should receive a copy of your notice by e-mail within 24 hours.

Note: All successfully submitted Jury Summons Response forms will generate an automated CONFIRMATION email, sent to the Applicant's email address as entered on this form. If you do not receive a confirmation email, your form may not have been received.

Please also ensure you are using a modern up-to-date web browser, such as Edge or Chrome, and DO NOT "copy and paste" information into any of the fields in this form. Please only submit this form once.

Other Useful Links:

Jury Summons Response Form

Section A - Qualifications of Jurors

Section B - Exclusion From Jury Service

Section C - Exemption From Jury Service

Court of King's Bench of Alberta

Other Useful Links: