Pro Se Filer in CM/ECF Name: Telephone Number: Email Address: Address: Fax Number: City: State: Zip Code: The undersigned agrees to abide by all Court rules, orders, and policies and procedures governing the use of the electronic filing system. The combination of user id and password serves as the signature of the filer pursuant to Fed. R. Civ. P. 11, the Federal Rules of Civil Procedure, the Federal Rules of Criminal Procedure and the local rules of this court. Filers must protect the security of their passwords and immediately notify the office of the clerk of court if they learn that their password has been compromised. The undersigned also consents to receiving electronic notice of filings in accordance with the provisions of Fed. R. Civ. P. 5(b)(2)(D), Fed. R. Civ. P. 77(d), and Fed. R. Crim. P. 49(b). Signature: Submit completed registration form to: Date: COURT USE ONLY: United States District Court Western District of Wisconsin Attention: ECF Registration - Room 320 120 North Henry Street Madison, Wisconsin 53703 A password change email will be sent containing your account login ID and a link to allow you to set your password. This login and password will then let you file in CM/ECF. Contact the clerk's office at 608-264-5156 with any questions concerning registration or CM/ECF. Assigned Login: Confirmation e-mail with login sent E-mail address confirmed by filer CM/ECF Account created Password e-mailed to filer Submitted Date: 2/9/2009 9:56 AM American LegalNet, Inc. www.FormsWorkFlow.com