Jury Service Loss of Earnings Claim UK (Form 5223)

Overview

The loss of earnings and benefits claim form is issued by HM Courts and Tribunals Service to jurors who are not paid by their employer while attending court. It acts as the formal route for the court to reimburse you, within set daily limits, for income you have lost because you have been called to serve.

The form has two main parts. The first is completed by you, the juror, and asks for your personal details, your juror number, your employer's name and address, and your job title. The second part is filled in by your employer.

They must confirm your usual net daily earnings and state whether you are still able to come back to work for part of the day or whether you will be away for the full period of service. The employer signs a declaration that the figures are accurate, as giving false information is a criminal offence. Once both parts are complete, the form is submitted to the court so that payment can be arranged.

Key steps

1. Receive your jury summons and notify your employer. Once you receive the summons from HMCTS, tell your employer as soon as possible so they can plan for your absence. Ask them whether they intend to keep paying you during your time at court, because this directly affects whether you need to make a loss of earnings claim at all.
2. Download the correct form from gov.uk. The loss of earnings and benefits claim form is available on the gov.uk website. Make sure you are using the current version, because older forms may reference outdated daily rates or contain fields that no longer match what the court expects to see when processing your claim.
3. Complete the juror section. Fill in your full name, juror number from the summons, job title, and your employer's registered business name and address. Accuracy matters here because any mismatch between what you write and what your employer later confirms can delay the court's assessment of your reimbursement.
4. Hand the form to your employer for completion. Your employer must enter your net daily earnings (take-home pay after tax and National Insurance) and indicate whether you can return for part of the working day. They then sign the declaration, provide their job title, contact details, and date, confirming the information is true.
5. Submit the form to the court within the deadline. Return the completed form to the jury central summoning bureau or the specific court address shown on your paperwork, within the timeframe they specify. Keep a copy for your records in case the court needs to follow up on any detail before releasing payment.