Efiling Registration Form

UNITED STATES DISTRICT COURT FOR THE WESTERN DISTRICT OF MICHIGAN E-FILING REGISTRATION FORM **Please type; this will also serve as a return mailing label** Name: _______________________________ Firm: _______________________________ Addr.: _______________________________ _______________________________ _______________________________ __ Phone: ____________________ This form cannot be submitted electronically. Complete the form on-line, print a hard copy, sign, scan and present it to the Clerk at the e-mail address below. A login and password for access to the electronic case filing system will be issued to you upon receipt of the fully-completed form. All of this information is required and must be supplied, including your original signature. Primary e-mail address: ______________________ (Attorney's e-m ail for electronic service) State Bar Number: _______________________ (and state, if not Michigan) Secondary e-mail address:____________________ (C entral repos itory, Sec retary, etc.) Date of admission to the Bar of this court: _______ **NOTE: A PACER ACCOUNT IS NECESSARY FOR VIEWING ELECTRONIC DOCUMENTS** E-mail software used: _______________________ (i.e., O utlook, G roupw is e, etc.) I have an existing PACER account. My firm has an existing PACER account. I already have an ECF login that I use in_______________________________, which is_____________; (N am e of O ther D istrict) (Login) please assign the same login for my use in the Western District of Michigan. The information contained in this box will be used for security/confirmation purposes related to your e-filing login/password: Key word/phrase: _________________________________ Reminder: ___________________________________________ City where your mother was born BY C OM PLET ING T HIS FOR M , AT T OR NEY S C ER T IFY T HAT T HEY ARE M EM BER S IN G OOD ST ANDING OF THE BAR OF THIS C OUR T AND T HAT T HEY AR E FAM ILIAR W IT H W .D. M ich. LC ivR 5.7 and LC rR 49.10, AS APPLIC ABLE T O T HEIR PR AC T IC E, W HIC H M AY BE FOUND AT : www.miwd.uscourts.gov By registering under this rule, attorneys consent to electronic service of all electronically filed documents. See W.D. Mich. LCivR 5.7(i)(ii) and LCrR 49.10(h)(ii). Attorney's Signature: Scan and return this form via e-mail to: ecfhelp@miwd.uscourts.gov YOUR E-FILING LOGIN AND PASSWORD WILL BE SENT TO YOU VIA E-MAIL C OURT USE ONLY: E-Filing Login Assigned: ____________________ E-Filing Password Assigned: _________________ 9 C onfirm ation e-m ail s ent 9 Attorney's record updated 9 E-m ail confirm ed by attorney 9 U R registered e-m ail sent American LegalNet, Inc. www.FormsWorkFlow.com