County Court District Court ____________________________________ County, Colorado Court Address: Plaintiff(s)/Petitioner(s): v. COURT USE ONLY Defendant(s)/Respondent(s): Attorney or Party Without Attorney (Name and Address): Case Number: Phone Number: FAX Number: Division E-mail: Atty. Reg. #.: Courtroom CONSENT TO ASSIGNMENT TO MAGISTRATE PURSUANT TO COLORADO RULES FOR MAGISTRATES My name is _____________________________________, (After reading carefully, check one of the boxes below.) I am a Plaintiff/Petitioner in this case. I am counsel for a Plaintiff/Petitioner in this case. I am a Defendant/Respondent in this case. I am counsel for a Defendant/Respondent in this case. (Attorneys only) I represent the following party or parties: __________________________________________ __________________________________________________________________________________________ IMPORTANT NOTICE Each Plaintiff/Petitioner and Defendant/Respondent in a case must fill out a separate consent form. You cannot consent for another party unless you are that person’s attorney. Spouses cannot consent for each other. I do consent to a Magistrate presiding at all hearings and rulings on all motions or the ____________________________ (name of proceeding) in this case. I understand that if I do not consent, the case will be handled by the assigned Judge. I also understand that if I do consent, I cannot withdraw my consent at a later time. I do not consent to a Magistrate presiding at all hearings and rulings on all motions or the___________________________ (name of proceeding) in this case. I understand that if I do not consent, the case will be handled by the assigned Judge. Date: __________________________________ ___________________________________________ Signature CERTIFICATE OF SERVICE I certify that on _______________________ (date) an original was filed with the Court and a true and accurate copy of the CONSENT TO ASSIGNMENT TO MAGISTRATE was served on the other party by: Hand Delivery, E-filed, Faxed to this number ____________________, or by placing it in the United States mail, postage pre-paid, and addressed to the following: To: ___________________________________ ___________________________________ ___________________________________ JDF 405 R6/08 CONSENT TO ASSIGNMENT TO MAGISTRATE ______________________________________ (Your signature) American LegalNet, Inc. www.FormsWorkflow.com