Criminal

Claim for loss of earnings or benefits during jury service: Forms 5223C and 5223D

Claim for loss of earnings if your employer is not paying you during jury service. Benefits claimants can claim for loss of benefits if doing jury service for more than 8 weeks.

This is a reference summary, not the official form.

Do not file this page. Always download and submit the current official form from the issuing authority.

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Documents

Claim for loss of earnings during jury service: Form 5223D
PDF
Hawlio am enillion a gollwyd yn ystod gwasanaeth rheithgor: Ffurf 5223D
PDF
Claim for loss of benefits after 8 weeks of jury service: Form 5223C
PDF
Hawlio am fudd-daliadau a gollwyd yn dilyn 8 wythnos o wasanaethu ar reithgor: Ffurf 5223C
PDF

Collection: Jury Service forms

Published: 2016-08-01

Updated: 2026-02-05

Last ingested: 2026-08-24 from GOV.UK. Description and document list reproduced verbatim.

Official source: GOV.UK, Open Government Licence v3.0