U.S. DISTRICT COURT MIDDLE DISTRICT OF LOUISIANA PRO SE E-SERVICE & E-NOTICE CONSENT FORM In accordance with the provisions of F.R.Civ.P.5(b)(2)(D), I understand that service will be given to me by electronic means to the primary e-mail address listed below. I agree to waive the provisions of F.R.Civ.P.77(d) and F.R.Crim.P.49(c) providing service of notice of the entry of an order or judgment by mail and consent that such notice may be served by electronic means. I understand that this electronic service and notice will be in lieu of notice by mail in any case in which this capability exists. I understand it is my responsibility to provide the Clerk's Office with a primary electronic mail address and to notify the Clerk's Office immediately if this primary electronic mail address changes. I understand that electronic mail filter software (SPAM filter) may interfere with receipt of email from the Clerk's Office, and I have verified that any such software installed on my computer or network will not filter out messages sent from enoticing@lamd.uscourts.gov. Please TYPE the following information or use the FILL-IN form on the court's website at www.lamd.uscourts.gov/cmecf Name: Address 1: Address 2: City, State, Zip: Phone #: Fax #: Primary Email Address For E-SERVICE and E-NOTICE: _____________________________________________________________________________ Signature Date FAX signed form to 225-389-3550 (no cover sheet required) American LegalNet, Inc. www.FormsWorkFlow.com