Fill and Sign the 491 Consent to Proceedmisdemeanor Form

฀AO86A (Rev. 4/91) Consent to Proceed ฀Misdemeanor U NITED STATES DISTRICT COURT DISTRICT OF UNITED STATES OF AMERICA V. CONSENT TO PROCEED BEFORE UNITED STATES MAGISTRATE JUDGE IN A MISDEMEANOR CASE Case Number: The United States magistrate judge has explained to me the nature of the offense (s) with which I am charged and the maximum possible penalties which might be imposed if I am found guilty. The magistrate judge has informed me of my right to the assistance of legal counsel. The magistra te judge has informed me of my right to trial, judgment, and sentencing before a United States district judge or a United States magistrate judge. I HEREBY: Waive (give up) my right to trial, judgment, and sentencing before a United States district judge, and I consent to trial, judgment and sentencing before a United States magistrate judge. X , Defendant WAIVER OF RIGHT TO TRIAL BY JURY The magistrate judge has advised me of my right to trial by jury. I HEREBY: Waive (give up) my right to trial by jury . Defendant Consented to by United States Signature Name and Title WAIVER OF RIGHT TO HAVE THIRTY DAYS TO PREPARE FOR TRIAL The magistrate judge has also advised me of my right to have at least thirty days to prepare for trial before the magistrate judge. I HEREBY: Waive (give up) my right to have at least thirty days to prepare for trial. X , Defendant Approved By: Defendant ฀s Attorney (if any) U.S. Magistrate Judge Date