1 2 UNITED STATES DISTRICT COURT 3 Northern District of California Clear Form 4 5 6 Case No. ____________________ 7 Plaintiff(s), v. 8 CONSENT TO ASSIGNMENT OR REQUEST FOR REASSIGNMENT 9 Defendant(s). _____________________________________/ 11 For the Northern District of California UNITED STATES DISTRICT COURT 10 12 Note: Please complete either Part A or Part B below and file with the Clerk of Court. A. CONSENT TO PROCEED BEFORE A UNITED STATES MAGISTRATE JUDGE 13 In accordance with the provisions of Title 28 U.S.C. Section 636(c), the undersigned party to the 14 above-captioned civil matter hereby voluntarily consents to have a United States magistrate judge conduct any 15 and all further proceedings in the case, including trial, and order the entry of a final judgment. 16 17 _______________________________ Signature 18 Counsel for ______________________ (Name of party or indicate "pro se") Dated: 19 20 B. REQUEST FOR REASSIGNMENT TO A UNTIED STATES DISTRICT JUDGE FOR TRIAL AND DISPOSITION 21 22 The undersigned party hereby declines to consent to the assignment of this case to a United States 23 magistrate judge for trial and disposition and hereby requests the reassignment of this case to a United States 24 district judge. 25 26 Dated: _______________________________ Signature 27 Counsel for ______________________ (Name of party or indicate "pro se") 28 2001 © American LegalNet, Inc.