UNITED STATES DISTRICT COURT District of Oregon
[Plaintiff], Plaintiff(s) vs. [Defendant], Defendant(s). Case No: 3:05-CV-[Case No.]-HA
Consent to Jurisdiction by a Magistrate Judge and Designation of the Normal Appeal Route In accordance with Fed. R. Civ. P 73(b), as counsel for the party (parties) identified below, I consent to have a United States Magistrate Judge conduct any and all proceedings in this case, including entry of orders on dispositive motions, trial, and entry of final judgment. I understand that withholding consent will not result in any adverse consequences. In accordance with Fed. R. Civ. P. 73(c), I agree that any appeal from a final order or judgment entered by a United States Magistrate Judge shall proceed directly to the United States Court of Appeals for the Ninth Circuit, and not to a District Judge of this Court. DATED:
Signature: Name & OSB ID: e-mail address: Firm Name: Mailing Address: City, State, Zip: Phone Number: Parties Represented cc: Counsel of Record
M agistra te Co nse nt Fo rm
Revised December 1, 2004