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IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW MEXICO

Plaintiff(s), -vsCivil No. ___________________________

Defendant(s).

CONSENT TO PROCEED / REFUSAL TO CONSENT TO PROCEED BEFORE A UNITED STATES MAGISTRATE JUDGE In accordance with 28 U.S.C. § 636(c) and Rule 73(b) of the Federal Rules of Civil Procedure, the above-entitled action has been assigned to United States Magistrate Judge: _______________________________________________ to conduct all proceedings in this case, including trial, entry of final judgment, and all post-judgment proceedings. Exercise of this jurisdiction by a U. S. Magistrate Judge is permitted only if all parties consent. Indicate below if you consent to the assignment or if you refuse to consent:

G Consent
___________________________________ Party(s) ___________________________________ Signature Date

G Refuse
___________________________________ Party(s) ___________________________________ Signature Date

Return this form to the Clerk's Office within 20 days of receipt if you are a pro se litigant. If you are an attorney/e-filer, please visit our Web site at www.nmcourt.fed.us for e-filing instructions. If consent by each party is not received within 20 days, the matter will be reassigned to a district judge who will serve as the presiding judge.

DNM (Rev. 05/09) Consent/Refusal to MJ