IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF NEBRASKA

_____________________________,	)	Case Number: ___:___CV__________

)

Plaintiff,	)

)

v.	)	CONSENT TO EXERCISE

)	OF JURISDICTION BY A

)	UNITED STATES MAGISTRATE JUDGE

_____________________________,	)	AND

)	ORDER OF REFERENCE

Defendant	)

CONSENT TO EXERCISE OF JURISDICTION BY A 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 this circuit.

Signature of Attorney or Party	Name of Party	Date

_______________________________	For ________________________________ ______________

_______________________________	For ________________________________ ______________

_______________________________	For ________________________________ ______________

_______________________________	For ________________________________ ______________

_______________________________	For ________________________________ ______________

ORDER OF REFERENCE

IT IS HEREBY ORDERED that this case be referred to the Honorable ___________________ ______________________, United States Magistrate Judge, for all further proceedings and the entry of judgment in accordance with 28 U.S.C. § 636(c), Fed. R. Civ. P. 73 and the foregoing consent of the parties.

_____________________________	____________________________________________________

Date	United States District Judge

clerk\proc\forms\consent.frm

04/13/11