UNITED STATES DISTRICT COURT EASTERN DISTRICT OF CALIFORNIA Plaintiff(s)/Petitioner(s), vs. CASE NO. Defendant(s)/Respondents(s). IMPORTANT IF YOU CHOOSE TO CONSENT OR DECLINE TO CONSENT TO JURISDICTION OF A UNITED STATES MAGISTRATE JUDGE, CHECK AND SIGN THE APPROPRIATE SECTION OF THIS FORM AND RETURN IT TO THE CLERK'S OFFICE. CONSENT TO JURISDICTION OF UNITED STATES MAGISTRATE JUDGE In accordance with the provisions of Title 28, U.S.C Sec. 636(c)(1), the undersigned hereby voluntarily consents to have a United States Magistrate Judge conduct all further proceedings in this case, including trial and entry of final judgment, with direct review by the Ninth Circuit Court of Appeals, in the event an appeal is filed. Date: ___________________ Signature: _______________________________ Print Name: ______________________________ ( ) Counsel for *___________________________ ( ) Plaintiff/Petitioner ( ) Defendant/Respondent DECLINE OF JURISDICTION OF UNITED STATES MAGISTRATE JUDGE Pursuant to Title 28, U.S.C. Sec 636(c)(2), the undersigned acknowledges the availability of a United States Magistrate Judge but hereby declines to consent. Date: ___________________ Signature: _______________________________ Print Name: ______________________________ ( ) Counsel for *___________________________ ( ) Plaintiff/Petitioner ( ) Defendant/Respondent *If representing more than one party, counsel must indicate name of each party responding. www.FormsWorkFlow.com