(Rev. 9/6/13) UNITED STATES DISTRICT COURT WESTERN DISTRICT OF LOUISIANA CONSENT TO RECEIVE NOTICE AND SERVICE ELECTRONICALLY In our continuing efforts to implement CM/ECF (Case Management/Electronic Case Filing), the Western District of Louisiana will no longer support its fax notification system; however, CM/ECF does allow for e-mail service of notice of the entry of an order or judgment Please indicate your consent to receive electronic notification by completing and signing the form below. (First Name) (Middle Name) (Last Name) (Gen.) (Bar Roll No.) In accordance with the provisions of Fed.R.Civ.P. 5(b), I understand that service, except for original process, will be given to me by electronic means to the primary e-mail address listed below. I agree to waive the provisions of Fed.R.Civ.P. 77(d) and Fed.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 via the court's electronic filing system in all cases where I appear as attorney of record. **Note: For security reasons, viewing documents in Social Security cases will require a CM/ECF login and password. There is no charge for the login and password, but training may be necessary. To obtain one, please visit our website at www.lawd.uscourts.gov. I understand that is my responsibility to advise the Clerk's Office promptly in writing of any electronic mail or physical address changes. I understand that electronic mail filter software (SPAM filter) may interfere with receipt of e-mail notices and have verified that any such software installed on my computer or network will not filter out messages sent from Clerk@lawd.uscourts.gov. I understand this electronic notice will be in lieu of notice by any other means. Please TYPE or LEGIBLY PRINT the following information: Firm: Address: City: Phone: Primary e-mail: Secondary e-mail(s) (e.g., secretaries, paralegals, etc. Do not include co-counsel): State: FAX: Zip Code: (Signature) (Date) Please return the completed form via fax to: 318-676-3962 or 318-934-4715. American LegalNet, Inc. www.FormsWorkFlow.com