JAN j 6 2010 - United States District Court

)
Plaintiff,)
)
vs.)
)
Defendant.)
)
CONSENT TO PROCEED BEFORE A UNITED STATES MAGISTRATE JUDGE
In accordance with the provisions of Title 28, United States Code, Section
636 (c), the parties to the above-captioned civil matter hereby waive their
right to proceed before a District Judge of this Court and consent to have a
Magistrate Judge conduct any and all further proceedings in the case (including
the trial) and order the entry of judgment.
Attorney Name (Bar Number)Attorney Name (Bar Number)
Attorney E-mail AddressAttorney E-mail Address
Firm NameFirm Name
Street AddressStreet Address
City, State, Zip CodeCity, State, Zip Code
Telephone: (xxx)xxx-xxxxTelephone: (xxx)xxx-xxxx
Facsimile: (xxx)xxx-xxxxFacsimile: (xxx)xxx-xxxx
Attorneys for Plaintiff [Party Name(s)]Attorneys for Defendant [Party
Name(s) ]
NOTE: Return this form to the Clerk of the Court only if it has been executed
by all parties to the case.
ORDER OF REFERENCE
IT IS HEREBY ORDERED that the above-captioned matter be referred to Magistrate
judge for the conduct of all further proceedings and the entry of
judgment in accordance with Title 28, United States Code, Section 636(c) and
the foregoing consent of the parties.
DateUnited States Magistrate Judge
159