IMPORTANT NOTICE: AFTER ALL PARTIES HAVE SIGNED THIS FORM, E-MAIL IT IN .PDF TO clerk@ned.uscourts.gov. IF PLAINTIFF IS PRO SE, MAIL TO THE CLERK'S OFFICE AT 111 South 18th Plaza, Suite 1152, Omaha, NE 68102. IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEBRASKA _____________________________, Plaintiff, v. ) ) ) ) ) ) ) ) ) ) Case Number: ___:___CV__________ _____________________________, Defendant CONSENT TO EXERCISE OF JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE AND ORDER OF REFERENCE CONSENT TO EXERCISE OF JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE In accordance with the provisions of 28 U.S.C. § 636(c) and Fed. R. Civ. P. 73, the parties in this case hereby voluntarily consent to have a United States magistrate judge conduct any and all further proceedings in the case, including the trial, and order the entry of a final judgment. Any appeal shall be taken to the United States court of appeals for this circuit. Signature of Attorney or Party Name of Party Date ______________ ______________ ______________ ______________ ______________ _______________________________ For ________________________________ _______________________________ For ________________________________ _______________________________ For ________________________________ _______________________________ For ________________________________ _______________________________ For ________________________________ ORDER OF REFERENCE IT IS HEREBY ORDERED that this case be referred to the Honorable ___________________ ______________________, United States Magistrate Judge, for all further proceedings and the entry of judgment in accordance with 28 U.S.C. § 636(c), Fed. R. Civ. P. 73 and the foregoing consent of the parties. _____________________________ Date ____________________________________________________ United States District Judge clerk\proc\forms\consent.frm 04/13/11 American LegalNet, Inc. www.FormsWorkFlow.com