[Your letterhead, if desired; if not, your return address]

[Date of letter-month, day, and year]

[Recipient's first and last names]
[Company name]
[Street or P.O. box address]
[City, State ZIP code]

Dear [recipient's name]:

I have received notification that my presence is required at jury duty on Monday, September 6, 2010. Although I would be more than willing to serve and to fulfill my duty as a citizen under different circumstances, my life situation makes it impossible for me to serve. More specifically, I have three very young children, including a 4-month-old baby, and they require my constant attention and care. Therefore, I am contacting you to respectfully request that I be excused from jury duty.

Please respond to let me know whether you need additional information and whether your office has granted me an excuse from jury duty. Thank you in advance for considering this request. I look forward to hearing from you in the near future.

Sincerely,

 

[Signature]

[Sender's first and last names]