Para poder solicitar una descalificación, debe cumplir uno de los siguientes criterios que se enumeran a continuación. Si no cumple alguno de estos criterios, sólo podrá solicitar un aplazamiento. Motivo de la descalificación Motivo de la descalificación I am under 18 years old. (Note: Must be at least 18 years old to serve; there is no upper age limitation) I am not a citizen of the United States. (Note: To serve as a juror, you must have been born in the U.S. or have been Naturalized) I cannot read, speak, or understand the English language. I do not reside or live in the county where I have been summoned more than 50% of the time or I have no intention of returning to the county at any time within the next 12 months. (Note: If you are a student, military member, or travel often but still reside in this county, you must still appear. You may request a postponement to delay your service – see Section 2: Requesting a postponement.) I have been selected and served as an impaneled juror in any municipal, tribal, military, state, or federal court within the last 12 months OR I am scheduled for jury service within the next 12 months. (You must attach proof of prior or pending service.) I am currently serving as a juror OR I have served as a juror within the last 12 months OR I have reported for jury service this calendar year OR I am scheduled for jury service within the next 12 months. I have a physical or mental disability that prevents me from serving. (You must attach a statement from a licensed physician or physician assistant authorized under C.R.S. 12-240-107(6), licensed advanced nurse practitioner, or authorized Christian Science practitioner.) I am solely responsible for the daily care of a permanently disabled person living in the same household, am not regularly employed at a location other than my household and serving as a juror would cause substantial risk of injury to their health. (You must attach a statement from a licensed physician or physician assistant authorized under C.R.S. 12-240-107(6), licensed advanced nurse practitioner, or authorized Christian Science practitioner.) I am breastfeeding a child and am temporarily unable to leave the child. (You must attach a medical statement.) The juror named on the summons is deceased. Supporting Disqualification Documentation If you selected that you are currently serving as a juror OR I have served as a juror within the last 12 months OR I have reported for jury service this calendar year OR I am scheduled for jury service within the next 12 months: You must attach verification of previous service or upcoming service with this request.If you selected that you have a serious physical or mental illness and would like to be excused you must attach a statement from a licensed physician, licensed physician assistant authorized under section 12-240-107(6), licensed advanced practice registered nurse, or authorized Christian science practitioner stating you are unable to perform jury service, and the length of the disqualification with this request. Request For Medical Disqualification Or Postponement From Jury Service (C.R.S. § 13-71-105)If you selected that you have the sole responsibility for the daily care of a permanently disabled person living in the same household and do not work outside the home you must attach a statement from a licensed physician, licensed physician assistant authorized under section 12-240-107(6), licensed advanced practice registered nurse, or authorized Christian science practitioner stating you are unable to perform jury service with the above information with this request. Request For Caretaker Postponement From Jury ServiceIf you selected that you are breastfeeding a child and am temporarily unable to leave the child and would like to be excused you must attach a medical statement, which can be from a medical professional such as a doctor, lactation professional, nurse, physician’s assistant and/or other medical professional stating you are unable to perform jury service because you are a nursing mother with this request. Máximo 1 fichero.límite de 100 MB.Tipos permitidos: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. Información de convocatoria Condado (como aparece en su citatorio - obligatorio)? – Seleccionar –Adams CountyAlamosa CountyArapahoe CountyArchuleta CountyBaca CountyBent CountyBoulder CountyBroomfield CountyChaffee CountyCheyenne CountyClear Creek CountyConejos CountyCostilla CountyCrowley CountyCuster CountyDelta CountyDenver - DistrictDenver - JuvenileDenver - ProbateDolores CountyDouglas CountyEagle CountyEl Paso CountyElbert CountyFremont CountyGarfield CountyGilpin CountyGrand CountyGunnison CountyHinsdale CountyHuerfano CountyJackson CountyJefferson CountyKiowa CountyKit Carson CountyLa Plata CountyLake CountyLarimer CountyLas Animas CountyLincoln CountyLogan CountyMesa CountyMineral CountyMoffat CountyMontezuma CountyMontrose CountyMorgan CountyOtero CountyOuray CountyPark CountyPhillips CountyPitkin CountyProwers CountyPueblo CountyRio Blanco CountyRio Grande CountyRoutt CountySaguache CountySan Juan CountySan Miguel CountySedgwick CountySummit CountyTeller CountyWashington CountyWeld CountyYuma County Ubicación (como aparece en su citatorio - obligatorio? – Seleccionar –Adams County Justice CenterAlamosa Combined CourtArapahoe County Courthouse - LittletonArapahoe County Justice CenterArchuleta County CourthouseBaca County CourtBent Combined CourtBoulder County Combined CourtBoulder County Combined Court - LongmontBroomfield Combined CourtsChaffee Combined Court Cheyenne County CourthouseClear Creek County CourthouseConejos Combined CourtCostilla Combined CourtCrowley Combined CourtCuster Combined Court Delta County Combined CourtDenver City & County Bldg (Civil and Domestic Matters)Denver Juvenile CourtDenver Probate CourtDolores Combined CourtDouglas County CourthouseEagle County - El JebelEagle County Justice CenterEl Paso County Judicial BuildingElbert County CourthouseFremont Combined Court Garfield County Associate Court - RifleGarfield County CourthouseGilpin Combined CourtGrand County Judicial CenterGunnison County Combined CourtHinsdale County CourthouseHuerfano County Judicial CenterJackson County Combined CourtJefferson Combined CourtKiowa County Combined CourtKit Carson County Combined CourtLa Plata County CourthouseLake County Combined CourtLarimer County Justice Center Las Animas County CourthouseLincoln County CourthouseLindsey-Flanigan Courthouse (Criminal Matters)Logan County Combined CourtsLoveland County Court Mesa County Justice CenterMineral Combined CourtMoffat Combined CourtMontezuma Combined CourtsMontrose County Justice CenterMorgan Combined CourtNucla Montrose Associate CourtOtero Combined CourtOuray County CourthousePark Combined CourtPhillips Combined CourtPitkin County CourthousePlaza WestProwers County Combined CourtPueblo Combined CourtRalph L. Carr Judicial CenterRio Blanco Combined CourtRio Blanco County Associate Court Rio Grande Combined CourtRoutt County Combined CourtSaguache Combined CourtSan Juan County CourthouseSan Miguel County CourthouseSedgwick Combined CourtState Court Administrator's OfficeSummit County Justice CenterTeller County CourthouseWashington Combined CourtWeld County Centennial CenterWeld County CourthouseYuma County Courthouse Fecha de comparecencia (obligatorio) Número de jurado en el citatorio (obligatorio) Información de contacto del miembro del jurado Su nombre tal como aparece en la citación del jurado Su apellido tal como aparece en la citación del jurado Mi nombre cambió Ingrese su nuevo nombre Su dirección de correo electrónico (obligatorio) Su teléfono (obligatorio) Vivo fuera de los Estados Unidos Esta es una nueva dirección. Dirección postal Dirección actual (obligatorio) Apartado postal / N.º de departamento Ciudad (obligatorio) Estado (requerido) - Ninguno -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaAmerican SamoaGuamNorthern Mariana IslandsPuerto RicoUnited States Minor Outlying IslandsVirgin Islands, U.S.Outside the US Código postal (obligatorio) Condado (obligatorio) - Ninguno -Out of State CountyAdamsAlamosaArapahoeArchuletaBacaBentBoulderBroomfieldChaffeeCheyenneClear CreekConejosCostillaCrowleyCusterDeltaDenverDoloresDouglasEagleEl PasoElbertFremontGarfieldGilpinGrandGunnisonHinsdaleHuerfanoJacksonJeffersonKiowaKit CarsonLa PlataLakeLarimerLas AnimasLincolnLoganMesaMineralMoffatMontezumaMontroseMorganOteroOurayParkPhillipsPitkinProwersPuebloRio BlancoRio GrandeRouttSaguacheSan JuanSan MiguelSedgwickSummitTellerWashingtonWeldYuma Mi dirección residencial es la misma que mi dirección postal. Dirección residencial Dirección actual (obligatorio) Apartado postal / N.º de departamento Ciudad (obligatorio) Estado (requerido) - Ninguno -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaAmerican SamoaGuamNorthern Mariana IslandsPuerto RicoUnited States Minor Outlying IslandsVirgin Islands, U.S.Outside the US Código postal (obligatorio) Condado (obligatorio) - Ninguno -Out of State CountyAdamsAlamosaArapahoeArchuletaBacaBentBoulderBroomfieldChaffeeCheyenneClear CreekConejosCostillaCrowleyCusterDeltaDenverDoloresDouglasEagleEl PasoElbertFremontGarfieldGilpinGrandGunnisonHinsdaleHuerfanoJacksonJeffersonKiowaKit CarsonLa PlataLakeLarimerLas AnimasLincolnLoganMesaMineralMoffatMontezumaMontroseMorganOteroOurayParkPhillipsPitkinProwersPuebloRio BlancoRio GrandeRouttSaguacheSan JuanSan MiguelSedgwickSummitTellerWashingtonWeldYuma Comentarios Al seleccionar esta casilla, certifico bajo pena de perjurio que la información anterior es verdadera y correcta. 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