ELECTRONIC SERVICE EXEMPTION FORMUNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIAFirm Name: Address: City: State: Zip Code: Telephone Number: Fax Number: E-mail Address: Name of Attorney: Cal. Bar Number: Pursuant to Local Rule 5-3.2.3, registering to use CM/ECF is deemed consent, for purposes of Fed. R. Civ. P. 5(b)(2)(E), to electronic service of documents through the CM/ECF System. CM/ECF users may revoke that consent at any time by completing this Electronic Service Exemption Form and submitting it to the Clerk's Office. Please note that this form may not be submitted or filed electronically, but must be submitted to the Clerk's Office in paper format, either in person (at any filing window) or by mail. Send to: United States District Court Attn: Attorney Admissions 255 East Temple Street, Suite TS-134 Los Angeles, CA 90012Please check one of the following: I am an attorney seeking admission to the Bar of the Central District of California. I am currently a member of the Bar of the Central District of California. I have been granted permission to appear pro hac vice in a case pending in the Central District.Please read and initial each of the following statements:I have (or have requested) a CM/ECF login and password, to allow me to file documents electronically in the Central District of California. However, I do not consent to be served with documents through the Court's CM/ECF System. I recognize that refusing to consent to electronic service will delay my receipt of both court orders and documents served by other parties to my case(s).I recognize that refusing to consent to electronic service will impose additional costs on the federal court system. I recognize that refusing to consent to electronic service will impose additional costs on other parties to my case(s), which may ultimately be taxed as costs against my client(s).G-5 (05/18)Page 1 of 1 ELECTRONIC SERVICE EXEMPTION FORMPlease sign below.I acknowledge that I have read and understood the above, and I withhold and/or revoke my consent to receive electronic service of documents through the Court's CM/ECF System. DateSignature of Attorney I am an attorney seeking permission to appear pro hac vice in a case pending in the Central District. Other (explain): American LegalNet, Inc. www.FormsWorkFlow.com