Western District of Missouri | United States Courts



United States District and Bankruptcy CourtsWestern District of MissouriPro Se Debtor Registration FormThis form shall be used by pro se debtors only to register for an account on the Court’s Case Management/Electronic Case Files (CM/ECF) system. Registered pro se debtors will receive electronic notice of documents filed in the Western District of Missouri CM/ECF system in those cases in which the registered user is the debtor appearing pro se. The following information is required for registration (please note that joint pro se debtors must have individual and separate e-mail addresses):Bankruptcy Case Number: ___________________Debtor InformationJoint Debtor (if any) Information_____________________________________________________________________First/Middle/Last Name First/Middle/Last Name _________________________________________________________Last Four Digits of Social Security Number Last Four Digits of Social Security Number _____________________________________________________________________Street Address Street Address _____________________________________________________________________City, State, ZipCity, State, Zip_____________________________________________________Phone NumberPhone Number_____________________________________________________________________Internet E-Mail Address Internet E-Mail Address (Joint Pro Se Debtors Must Have Individual and Separate E-Mail Addresses)A pro se debtor’s registration will constitute a waiver in law of conventional service of documents. No paper copy will be sent to the pro se debtor. The pro se debtor agrees that the CM/ECFgenerated notice of electronic service will constitute service of the electronic filing. The pro se debtor agrees to contact the court in writing to report any changes in the address, phone number, or e-mail address shown above. The pro se debtor is advised to “white list” the court’s e-mail address (mow_bkecf@mow.) to insure that court e-mail notices are delivered to the pro se debtor’s e-mail address._______________________________________________________________________Pro Se Debtor SignaturePro Se Joint Debtor (if any) Signature__________________________________________DateDate ................
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