UNITED STATES DISTRICT COURT District of Minnesota APPLICATION FOR PRO SE LITIGANT TO FILE ELECTRONICALLY Effective October 5, 2015 - I understand that in addition to completing this form, I will also need to sign up for an individual PACER account and apply for electronic filing access through the 223Non-Attorney E-File Registration224 option for the District of Minnesota through my PACER account. Pursuant to Fed. R. Civ. P. 5(e) and Local Rule 5.1, electronic case filing is authorized in the District of Minnesota and implemented by Court Order. Electronic case filing is governed by the standards and procedures set forth in the most recent version of the 223Electronic Case Filing Procedures for the District of Minnesota,224 which may be found on the Court222s website at www.mnd.uscourts.gov. The Court222s Electronic Case Filing (ECF) system is for use only in cases designated by the U.S. District Court for the District of Minnesota and may only be used to file electronic documents. In order to file electronic documents through ECF, pro se litigants must submit this application. Only pro se litigants who have a matter pending before the U.S. District Court for the District of Minnesota and are not prohibited from filing electronically in this Court may apply to file electronically on ECF. The Court reserves the right to add or remove conditions to this application. Upon review and approval of the application, the applicant will have privileges to electronically file documents with the Court and to receive electronic service of filings in their cases. Please note that electronic filing occurs through PACER and that the applicant must have a PACER account in order to electrically file. Pro Se Litigant Information and Certification First/Middle/Last Name: Street Address: City/State/Zip Code: Daytime Phone Number: ( ) E-mail Address: Pending Case Number(s) in this Court: By signing below, I certify that the information provided above is true and correct. Date: Signature: American LegalNet, Inc. www.FormsWorkFlow.com Page 2 Pro Se Litigant Consent Should my Application for Pro Se Litigant to File Electronically be approved, I, , the undersigned pro se litigant agree and consent to the following: To abide by the Federal Rules of Civil Procedure, the Federal Rules ofCriminal Procedure, and the Local Rules for the United States District Court for theDistrict of Minnesota.I understand that the provisions of Local Rule 5.1, 223Electronic Case Filing,224 the223Order Adopting Electronic Case Filing Procedures224 signed by the Court on May 17,2004, and the most recent version of the Court222s Civil and Criminal ECF ProceduresGuides for the District of Minnesota apply to electronic filing in this District and Iagree to abide by all provisions set forth therein.I agree that all my transmissions for electronic filings of pleadings and documentsto the ECF system shall be titled in accordance with the approved directory of civil andcriminal events in the ECF system.I understand and agree that I must obtain a PACER account in order to fileelectronically in the District of Minnesota. I understand that I can obtain a PACERaccount at: https://www.pacer.gov/I agree that the combination of my Username and Password will serve as mysignature for purposes of the Federal Rules of Civil and Criminal Procedure. I furtheragree to protect the security of my password. If I believe it is being used without mypermission, I will change my password and will inform the Clerk of Court by telephoneof the misuse.I have read and I understand the provisions of Federal Rule of Civil Procedure 11and I understand that the provisions of Rule 11 apply with full force and effect to alldocuments filed using ECF.I receive service of notice of Court Orders and judgmentselectronically through the Court222s ECF system under Federal Rule of Civil Procedure77(d) and Federal Rule of Criminal Procedure 49(c), and I thereby agree to waiveservice of such notice by other means under Federal Rules of Civil Procedure 5(b)(2)and 77(d) and Federal Rule of Criminal Procedure 49(c).I receive electronic service through the Court222s ECF system ofpleadings and other papers under Federal Rule of Civil Procedure 5, and I therebyagree to waive service by other means under Federal Rule of Civil Procedure 5(b)(2)and Federal Rule of Criminal Procedure 49, unless service by electronic means isnot allowed under the Federal Rules of Civil Procedure and Criminal Procedure. American LegalNet, Inc. www.FormsWorkFlow.com 9.I understand that I will receive the initial electronic copy of a document filed at nocharge when I am an official recipient of the document (the 223free look224 provision inECF). After that, I understand that all remote electronic access to the case filedocuments occurs through the Judiciary222s PACER system and I understand that I will becharged an access fee at a per-page rate. 10.I understand that I can view electronic documents and docket sheets in person at thefour divisional Clerk222s Offices in the District of Minnesota at no charge on the publicaccess terminals. 11.I understand that abuse of ECF access privileges will result in revocation of myECF access. 12.I understand that my ECF access will be deactivated following closure of mypending matter(s) and the expiration of all applicable appeal periods. 13.I agree to update any changes to my contact information, including my e-mailaddress, I must do so through my PACER account and/or using the Utilities tab in ECF. Date: Signature of Applicant: PLEASE MAIL OR DELIVER THIS APPLICATION TO: Warren E. Burger Federal Building and U.S. Courthouse Attn: Admissions 316 North Robert Street, Suite 100 St. Paul, MN 55101 *The Clerk of Court will not accept this application transmitted electronically or by facsimile.The application must be submitted to the Clerk of Court with the original ink or wet signature.PLEASE NOTE IN ADDITION to mailing or delivering this application to the above address, I understand that I MUST also apply for electronic filing access through the 223Non-Attorney E-File Registration224 option with the District of Minnesota through my PACER ACCOUNT. For detailed step by step instructions, click here. If you have any questions about this application form or the application process, please contact an Admissions Clerk at 651-848-1100 or the elpdesk at ecfhelpdesk@mnd.uscourts.gov. Page 3 American LegalNet, Inc. www.FormsWorkFlow.com