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AO 85A. Notice, Consent, and Reference of a Dispositive Motion to a Magistrate Judge

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AO 85A  (Rev. 01/09) Notice, Consent, and Reference of a Dispositive Motion to a Magistrate Judge 	
U	NITED 	S	TATES 	D	ISTRICT 	C	OURT	
for the
__________ District of__________
)
)
)
)
)	
Plaintiff	 
v. Civil Action No.	
Defendant	
NOTICE, CONSENT, AND REFERENCE OF A DISPOSITIVE MOTION TO A MAGISTRATE JUDGE 
Notice of a magistrate judge’s availability.  A United States magistrate judge of this court is available to conduct
all proceedings and enter a final order dispositive of each motion.  A magistrate judge may exercise this authority only if
all parties voluntarily consent.
You may consent to have motions referred to a magistrate judge, or you may withhold your consent without
adverse substantive consequences.  The name of any party withholding consent will not be revealed to any judge who
may otherwise be involved with your case.
Consent to a magistrate judge’s consideration of a dispositive motion.  The following parties consent to have a
United States magistrate judge conduct any and all proceedings and enter a final order as to each motion identified below	
(identify each motion by document number and title)	.
Motions:
Parties’ printed names Signatures of parties or attorneys Dates
Reference Order
IT IS ORDERED: The motions are referred to a United States magistrate judge to conduct all proceedings and
enter a final order on the motions identified above in  accordance with 28 U.S.C. § 636(c).
Date:	
District Judge’s signature
Printed name and title	
Note: Return this form to the clerk of court only if you are consenting to the exercise of jurisdiction by a United States 
magistrate judge.  Do not return this form to a judge.
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