JDF 631 Consent to Limited Appearance 10 - 11 District Court County Court County, Colorado Court Address: P laintiff : and Defendant : COURT USE ONLY Attorney (Name and Address) : Phone Number: E - mail: FAX Number: Atty . Reg. #: Case Number: Division Courtroom CONSENT TO LIMITED APPEARANCE BY AN ATTORNEY UNDER C.R.C.P. 11(b) AND 121, SECTION 1 - 1 (5) IN A CIVIL MATTER I, , (Pro se party name ) do hereby consent to granting a li mited entry of appearance to (name of counsel) for permission to represent me for the following proceeding(s) : . I understand that the Court retains jurisdic tion over me as the pro se party in interest to this case . T hat at the conclusion of this limited appearance I have the burden of keeping the Court and the other parties informed where later notices, pleadings, and other papers may be served; that I have t he obligation to prepare for trial or have other counsel prepare for trial; and that failure or refusal to meet these burdens may subject me to a possible default and that the dates of any proceedings including trial and holding of such proceedings will no t be affected by the completion of the limited appearance of counsel. Service of process may be served upon me as the pro se party in interest to this case at my address which is . DATE: Signature Name: Address: Telephone: American LegalNet, Inc. www.FormsWorkFlow.com