UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF TENNESSEE ________________________________________________________________________________________________________________ In re Case No. Debtor. Plaintiff, Chapter 11 vs. Adv. Proc. No. Defendants. ________________________________________________________________________________________________________________ EXPRESS CONSENT OF ALL PARTIES TO JURY TRIAL BY BANKRUPTCY JUDGE (COMBINED WITH RELATED MATTERS) _______________________________________________________________________________________________________ In accordance with 28 U.S.C. § 157(e), all the parties hereto expressly consent to a jury trial of the above-captioned civil proceeding before the Bankruptcy Judge (and also consent to the entry of a final order by the Bankruptcy Judge). Respectfully submitted, ____________________________ (Signature) _______________________________ (Signature) ____ __________________________ (Signature) Attorney for Plaintiff Attorney for Defendant Attorney for Defendant _____________________________ Name ___________________________________ Name __________________________________ Name ______________________________ Address, Line 1 _______________________________ Address, Line 1 ________________________________ Address, Line 1 ______________________________ Address, Line 2 ________________________________ Address, Line 2 _______________________________ Address, Line 2 ______________________________ City, State, Zip Code ________________________________ City, State, Zip Code _______________________________ City, State, Zip Code ( ( ) ________________________ ( ( )___________________________ Telephone Number ( ( )__________________________ Telephone Number Telephone Number )__________________________ )___________________________ Facsimile Number )__________________________ Facsimile Number Facsimile Number ______________________________ Disciplinary Number ________________________________ Disciplinary Number _______________________________ Disciplinary Number _______________________________ Date ________________________________ Date _______________________________ Date __________________ If all the parties to the above-captioned proceeding expressly consent that the Bankruptcy Judge conduct a jury trial, it shall be their collective responsibility to timely and jointly file this document with the Bankruptcy Clerk. See L.B.R. 9015-1. Unless all the parties to this proceeding expressly consent that the Bankruptcy Judge conduct a jury trial, this document should never be filed with the Bankruptcy Clerk. Failure to file this document shall be deemed by the Bankruptcy Judge that all the parties do not consent. A separate document reflecting only partial consent of one or more of the parties, but not all the parties, shall not be filed with the Bankruptcy Clerk. American LegalNet, Inc. www.USCourtForms.com