Spitters v. Unknown

Filing 18

AMENDED FURTHER ORDER RE: PLAINTIFFS IN FORMA PAUPERIS APPLICATION. Signed by Magistrate Judge Jacqueline Scott Corley on 1/6/2016. (Attachments: # 1 Consent Form, # 2 Certificate of Service)(ahm, COURT STAFF) (Filed on 1/6/2016)

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UNITED STATES DISTRICT COURT

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NORTHERN DISTRICT OF CALIFORNIA

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THOMAS H. SPITTERS,

Case No. 15-cv-04902-JSC

Plaintiff,
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v.

CONSENT OR DECLINATION
TO MAGISTRATE JUDGE
JURISDICTION

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UNKNOWN,
Defendant.

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United States District Court
Northern District of California

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INSTRUCTIONS: Please indicate below by checking one of the two boxes whether you
(if you are the party) or the party you represent (if you are an attorney in the case) choose(s) to
consent or decline magistrate judge jurisdiction in this matter. Sign this form below your selection.
( )

In accordance with the provisions of 28 U.S.C. § 636(c), I voluntarily consent to
have a United States magistrate judge conduct all further proceedings in this case, including trial
and entry of final judgment. I understand that appeal from the judgment shall be taken directly to
the United States Court of Appeals for the Ninth Circuit.

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Consent to Magistrate Judge Jurisdiction

OR
( )

Decline Magistrate Judge Jurisdiction

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In accordance with the provisions of 28 U.S.C. § 636(c), I decline to have a United
States magistrate judge conduct all further proceedings in this case and I hereby request that this
case be reassigned to a United States district judge.
DATE: ________________

NAME:
COUNSEL FOR
(OR “PRO SE”):

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Signature