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UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF ILLINOIS

ECF REGISTRATION FORM - PRO SE
To register for an account on this Court's Electronic Case Filing System (ECF), please complete the following information: [PLEASE TYPE] First Name: ___________________________________ Last Name: ___________________________________ Address: ________________________________________________________________________________________________ City:__________________________________________________ State:__________________ Zip Code:__________________ Telephone Number: ______________________________ Primary e-mail address:___________________________________
(Pro se party individual e-mail for purposes of receipt and confirmation of passw ord information)

Middle Name: ____________________________________________

Fax Number:____________________________________

Secondary e-mail address:_________________________________
(For purposes of ongoing notices of filing, e.g. central repository, secretary)

The undersigned agrees to abide by all Court rules, orders, and policies and procedures governing the use of the electronic filing system. The undersigned also consents to receiving notice of filings pursuant to Fed. R. Civ. P. 5(b)(2)(D) and Fed. R. Crim. P. 49(b) via the Court's electronic filing system. The combination of user id and password will serve as the signature of the pro se party filing the documents. Pro se parties must protect the security of their passwords and immediately notify the Court if they learn that their password has been compromised. The undersigned acknowledges that misuse of the password or violations of the Administrative Procedures for controlling electronic filing may subject the undersigned to sanctions pursuant to Fed. R. Civ. P. 11. Visit the PACER web site at http://pacer.psc.uscourts.gov to establish a PACER account. Signature_________________________________________________ Submit completed Registration Form to: Date _____________________________

Pamela E. Robinson, Clerk United States District Court Attention: Electronic Filing System Registration 600 E. Monroe St Room 151 Springfield, IL 62701 (217) 492-4020

COURT USE ONLY:

Login name sent via e-mail. Password will be sent via separate e-mail after confirmation of receipt of login name. Contact any of our divisional offices with questions concerning registration or ECF.

E - Filing Login Assigned: ______________________________________ E - Filing Password Assigned: __________________________________

Q

Pro se Party e-mail record updated

Q Password e-mailed to pro se party

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Confirmation e-mail with login sent

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Copy of form mailed to pro se

party