Crime-Victim and Witness Court-Attendance Leave Request Packet
COMPULSORY JUDICIAL-PROCEEDING ABSENCE REQUEST PACKET
Georgia — O.C.G.A. § 34-1-3
Use this packet when an employee must attend a judicial proceeding in response to a subpoena, summons for jury duty, or another court order or process requiring attendance.
1. EMPLOYEE AND EMPLOYER
| Field | Entry |
|---|---|
| Employee | [________________________________] |
| Employer | [________________________________] |
| Position / department | [________________________________] |
| HR / supervisor contact | [________________________________] |
| Preferred confidential contact | [________________________________] |
2. COMPULSORY-ATTENDANCE GATE
The employee received:
- ☐ Subpoena
- ☐ Summons for jury duty
- ☐ Other court order or process requiring attendance: [________________________________]
The employee is not charged with a crime in the proceeding for which this packet is used.
- ☐ Confirmed
- ☐ Uncertain; counsel review required
Court and jurisdiction: [________________________________]
Case or matter identifier, using the minimum necessary information: [________________________________]
Required appearance date and time: [________________________________]
Expected work absence or delayed reporting: [DATE / START / END]
Georgia Attorney General Official Opinion 95-13 concludes that section 34-1-3 includes qualifying judicial proceedings in another state. Obtain counsel review when the compulsory process was issued outside Georgia.
3. REASONABLE NOTICE
Section 34-1-3 permits an employer to require compliance with reasonable rules for notifying the employer of an expected absence or delayed reporting.
| Notice item | Entry |
|---|---|
| Date process received | [________________________________] |
| Notice date and time | [________________________________] |
| Notice method and recipient | [________________________________] |
| Expected absence or delay | [________________________________] |
| Scheduling update due | [________________________________] |
- ☐ Employer's reasonable notice procedure followed
- ☐ Notice provided as soon as practicable; explanation: [________________________________]
- ☐ Counsel review requested concerning the notice procedure
4. EMPLOYEE REQUEST
I request an absence or delayed-reporting adjustment from [START] through [END] on [DATE] to attend the judicial proceeding identified above as required by compulsory court process.
Pay or leave-bank treatment requested under policy, agreement, or another law:
- ☐ Accrued paid leave: [TYPE / HOURS]
- ☐ Unpaid time
- ☐ Schedule adjustment: [________________________________]
- ☐ Other: [________________________________]
This packet does not determine pay treatment under another law, policy, or agreement.
Employee signature: __________________________ Date: ______________
5. MINIMUM DOCUMENT DELIVERY
- ☐ Subpoena, summons, order, or process requiring attendance
- ☐ Scheduling or cancellation notice
- ☐ Other minimally necessary confirmation: [________________________________]
Do not attach police reports, medical records, victim addresses, or offense narratives unless current law or counsel requires them.
Secure delivery date, method, and recipient: [________________________________]
6. EMPLOYER REVIEW
Section 34-1-3 prohibits an employer or its agent from discharging, disciplining, otherwise penalizing, threatening, or communicating an intention to take such action because of a covered absence.
- ☐ Compulsory court process confirmed
- ☐ Judicial-proceeding attendance confirmed
- ☐ Charged-employee exclusion does not apply
- ☐ Reasonable notice procedure satisfied or exception reviewed
- ☐ Absence or delayed reporting approved
- ☐ Schedule adjusted without a prohibited penalty
- ☐ Pay / leave-bank treatment: [________________________________]
- ☐ Counsel review required
An employer or agent that violates subsection (a) may be liable to the injured employee for actual damages and reasonable attorney fees incurred in a successful claim.
Employer representative: _____________________ Date: ______________
Decision delivered to employee: [DATE / METHOD]
7. CHANGE LOG
| Date | Proceeding update | Employee notice | Work adjustment |
|---|---|---|---|
| [________] | [________________] | [________________] | [________________] |
| [________] | [________________] | [________________] | [________________] |
OFFICIAL SOURCES VERIFIED
- Digital Library of Georgia — 1987 Georgia Laws, volume I, pages 1156–1158 (Act No. 748 / SB 41)
- Georgia Attorney General — Official Opinion 95-13
- Liberty County Clerk of Courts — current jury-service employer information
- Georgia General Assembly — 2021 HB 350 introduced text
- Georgia General Assembly — 2022 HB 1457 introduced text
About This Template
Employment documents govern the relationship between a company and its workers, from offer letters and employment agreements through handbooks, performance reviews, and separations. Done right, they set clear expectations, protect against wrongful termination and discrimination claims, and give both sides a record to rely on. Done poorly, they invite lawsuits, agency complaints, and costly disputes.
Important Notice
This template is provided for informational purposes. It is not legal advice. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on 2026-08-11.
Legal authority: O.C.G.A. § 34-1-3 (compulsory judicial-proceeding attendance; notice, exclusion, and remedies)
Last updated: 2026-08-11
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