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Blank employer notice

Template only. You fill the brackets. Harborline does not send this for you.

[Date]

[Supervisor / HR name]
[Company]
[Address]

Re: Notice of federal jury service

I am writing to give notice that I have been summoned for jury service in the United States District Court for the [name the district printed on the summons].

The reporting date printed on the packet is [date]. The court, not me, controls whether I must appear that day and how long service lasts.

Federal law protects a permanent employee from being discharged, threatened, intimidated, or coerced because of federal jury service. See 28 U.S.C. § 1875. Federal law does not require a private employer to continue wages. Any wage continuation is a matter of company policy or a separate statute you should confirm.

I will give the court the contact information it requests and will send you any attendance certificate the clerk issues, if the court provides one.

Sincerely,
[Name]
[Employee ID if used]
[Phone]

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