28 USC App, FEDERAL RULES OF CIVIL PROCEDURE, Form 34: Consent to Exercise of Jurisdiction by a United States Magistrate Judge
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*Public Law 119-75 has been enacted, but classifications have not been finalized. The currency ("laws in effect") date does not reflect acts for which classifications have not been finalized.

28 USC App, FEDERAL RULES OF CIVIL PROCEDURE, Form 34: Consent to Exercise of Jurisdiction by a United States Magistrate Judge
From Title 28-AppendixFEDERAL RULES OF CIVIL PROCEDUREAPPENDIX OF FORMS
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Form 34. Consent to Exercise of Jurisdiction by a United States Magistrate Judge

UNITED STATES DISTRICT COURT

____________ DISTRICT OF ____________

  Plaintiff,

vs.    

}Docket No. ________

  Defendant.

CONSENT TO JURISDICTION BY A UNITED STATES MAGISTRATE JUDGE

In accordance with the provisions of Title 28, U.S.C. §636(c), the undersigned party or parties to the above-captioned civil matter hereby voluntarily consent to have a United States magistrate judge conduct any and all further proceedings in the case, including trial, and order the entry of a final judgment.

____________   XXXXXXXXXXXXXX

  Date      Signature

Note: Return this form to the Clerk of the Court if you consent to jurisdiction by a magistrate judge. Do not send a copy of this form to any district judge or magistrate judge.

(As added Apr. 28, 1983, eff. Aug. 1, 1983; amended Apr. 22, 1993, eff. Dec. 1, 1993; Apr. 11, 1997, eff. Dec. 1, 1997.)