UNITED STATES DISTRICT COURT DISTRICT OF CONNECTICUT , Plaintiff V. Case No. [Put case number here] , Defendant MOTION BY SELF-REPRESENTED LITIGANT TO PARTICIPATE IN ELECTRONIC FILING I am a Plaintiff/Defendant in this civil action. I have filed an appearance as a self-represented litigant, and I hereby request permission to file documents electronically. In so doing, I consent to the court and opposing counsel using my email address, as listed below, for the purpose of sending me electronic notification of orders, notices, and other documents that are filed in my case. I understand that hard copies will no longer be issued by the court or opposing counsel. I understand that if my motion is granted, I required training class on electronic filing for self-represented litigants and register for a PACER account, before I can actually begin filing documents electronically. I certify that I can comply with the following requirements: A computer with access to the internet. Internet Explorer (Version 11) or Mozilla Firefox (Version 49.x and higher) or Safari (Version 10.x and higher) or Chrome (Version 53.x and higher). Adobe Reader (Version 7 or greater). Ability to create PDF files. An upgraded PACER account. Name of Self-represented Litigant Street Address City, State, Zip Code Telephone Email Address Date Signature American LegalNet, Inc. www.FormsWorkFlow.com Certificate of Service I hereby certify that on [date], a copy of the foregoing Motion by Self- represented Litigant to Participate in Electronic Filingas filed and served by mail on the following: [insert name and address of every person served]. Signature of Self-represented Litigant Revised: November 29, 2017 American LegalNet, Inc. www.FormsWorkFlow.com