Form 5223B
| Published date | 21 March 2018 |
| Subject Matter | Jury service forms |
You should use this form if you need to claim extra costs
you incur for childcare or the care of elderly or vulnerable
adults during the days you serve as a juror. You may not
claim back costs you normally pay for care.
• If you work full time or part time and usually employ a
childminder, you may not claim childcare for the days
you would normally work, as you will not have incurred
any additional childcare costs as a direct result of jury
service.
• If your child(ren) normally attends an after-school club
or activities, then you may not claim childcare for those
hours, as you will not have incurred any additional
childcare costs as a direct result of jury service.
• If a grandparent, spouse, partner or friend takes annual
leave to look after your child(ren), the Court will not
pay their salary because their employer will normally
pay them during their annual leave. The Court does not
pay compensation to third parties, as there is no direct
loss to you as a result of jury service.
If friends or family members look after your child(ren) or
care for elderly/vulnerable adult(s) on your behalf, and
they charge you for this, you may claim up to £2.50 per
hour, per child/adult, towards this cost, up to 8 hours for a
full day at Court. This person must provide a letter to the
court with their full details, days and times they have cared
for your child(ren) before any payment can be made.
How to complete your form – You (the juror) should
complete section 1. You should then ask your childminder
or care provider to complete sections 2 or 3 then you
must sign the declaration.
Once the form is completed please return it with
supporting documents to the Jury Ocer.
Please speak to the Jury Ocer if you require further
information, or advice on how to complete this form.
Juror’s childcare/
vulnerable adult/elderly care
provision expenses claim
Age Full name
1.
2.
3.
4.
Section 1 — Your details (the juror)
Your name Your juror no.
Your address Name of Crown court
Postcode
List the people who required
childcare or other care
provision while you were
on jury service (If you care
for more than four people,
continue on a separate sheet).
Juror’s childcare/vulnerable adult/elderly care provision expenses claim (07.16)
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