Debtors Request To Receive Electronic Notice

UNITED STATES BANKRUPTCY COURT DISTRICT OF SOUTH DAKOTA DEBTOR'S REQUEST TO RECEIVE ELECTRONIC NOTICE Bankruptcy Case Number: Last Name: First Name: Middle Name: Last Four Digits of SSN: Mailing Address: City: State: Zip Code: Phone: Fax: E-mail Address: I request to receive electronic notice and consent to service by electronic means in this case and in any related adversary proceedings, when permitted under applicable rules and the Court's Electronic Case Filing Administrative Procedures. Date: ______________________ Signature of Debtor: ________________________________ Attorney for Debtor must file this document electronically in CM/ECF. If Debtor is not represented by an attorney, mail the original to: Frederick M. Entwistle, Clerk U.S. Bankruptcy Court 400 South Phillips Avenue, Room 104 Sioux Falls, SD 57104-6851 American LegalNet, Inc. www.FormsWorkFlow.com