UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WASHINGTON ) ) ) ) Plaintiff(s), ) ) v. ) ) ) ) ) Defendant(s). ) ___________________________________ ) Case Number: CONSENT TO PROCEED BEFORE A UNITED STATES MAGISTRATE JUDGE Pursuant to 28 U.S.C. 636(c), the parties in the captioned matter waive their right to proceed before a Judge of the United States District Court and consent to have a full-time United States Magistrate Judge conduct all further proceedings, including the trial and entry of the order of judgment. The parties are aware that appeals lie directly to the United States Court of Appeals for this Circuit. Plaintiff(s) Counsel: Defendant(s) Counsel: _____________________________________ Typed Name ___________________________________ Typed Name _____________________________________ Signature ___________________________________ Signature _____________________________________ Date ___________________________________ Date ORDER IT IS ORDERED that the captioned matter be referred to full-time United States Magistrate Judge ___________________________, who will conduct all further proceedings and enter judgment pursuant to 28 U.S.C. 636(c), under the parties' consent. The Clerk of the Court and counsel are directed to use the Magistrate Judge initials on all future pleadings. __________________________________ DATED ___________________________________ UNITED STATES DISTRICT JUDGE rf/Revised 12-15-2011 American LegalNet, Inc. www.FormsWorkFlow.com If you do not wish to consent to a Magistrate Judge, please return this page to: 6HDQ ) 0F$YR\ &OHUN RI &RXUW U.S. District Court, Eastern District of Washington P.O. Box 1493 Spokane, WA 99210-1493 Your response will remain confidential and will not be reflected in the file. I do not consent to a Magistrate Judge. Case Name: _______________________________________________________________ Case Number: _____________________________________________________________ Name of Attorney: __________________________________________________________ Name of Party: _____________________________________________________________ Signature of Attorney: _______________________________________________________ *This document is confidential and must be submitted to the Clerk's Office in paper format. Please do not electronically file this document. American LegalNet, Inc. www.FormsWorkFlow.com