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IN THE UNITED STATES DISTRICT COURT FOR THE CENTRAL DISTRICT OF ILLINOIS Danville/Urbana Division ) ) ) ) ) ) ) )

Plaintiff, v.

Case No.

Defendant.

CONSENT TO PROCEED BEFORE 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 waive their rights to proceed before a United States District Judge and consent to a United States Magistrate Judge conducting any and all further proceedings in the case, including the trial, and ordering the entry of a final judgment. FOR THE PLAINTIFF(S): __________________________________ DATE: ___________________________ __________________________________ DATE: ___________________________ __________________________________ DATE: ___________________________
(All plaintiffs or attorneys for plaintiffs must sign)

FOR THE DEFENDANT(S): ______________________________________ DATE: ______________________________ _____________________________________ DATE: ______________________________ _____________________________________ DATE: ______________________________
(All defendants or attorneys for defendants must sign)

ORDER IT IS ORDERED that this case is referred to the Honorable David G. Bernthal, United States Magistrate Judge, for all further proceedings and the entry of judgment, in accordance wtih 28 U.S.C. 636(c) and Fed.R.Civ.P. 73, and the foregoing consent of the parties. ENTER this _______ day of _______________, 19___.

______________________________________ UNITED STATES DISTRICT JUDGE
(NOTE: Return this form to the Clerk of Court only if all parties have consented on this form to proceed before a Magistrate Judge.)