Consent To Exercise Of Jurisdiction By United States Magistrate Judge Form
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1IMPORTANT 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
th
18 Plaza, Suite 1152, Omaha, NE 68102. DO NOT ELECTRONICALLY FILE THIS FORM OR SUBMIT
IT TO CHAMBERS.
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEBRASKA
_____________________________,
)
Case Number: __:___CV__________
)
Plaintiff(s),
)
CONSENT TO EXERCISE OF JURISDICTION
v.
)
BY A UNITED STATES MAGISTRATE JUDGE
)
_____________________________,
)
Defendant(s).
)
CONSENT TO EXERCISE OF JURISDICTION BY 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 the Eighth Circuit.
Signature of Attorney or Party
Name of Party
Date
_______________________________ For_________________________
______________________
_______________________________ For_________________________
______________________
_______________________________ For_________________________
______________________
______________________________ For_________________________
______________________
DISTRICT JUDGE OPTION
Pursuant to 28 U.S.C. § 636(c)(2) and Fed. R. Civ. P. 73, the parties in this case hereby acknowledge the
availability of a United States Magistrate Judge but elect to have this case randomly assigned to a United States District
Judge.
Signature of Attorney or Party
Name of Party
Date
_______________________________ For_________________________
______________________
_______________________________ For_________________________
______________________
_______________________________ For_________________________
______________________
______________________________ For_________________________
______________________
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