ACW CR-250 (4/19)(cs) AS 22.15.120 CONSENT TO TRIAL BY MAGISTRATE JUDGE Crim. R. 5(f)(3) IN THE DISTRICT COURT FOR THE STATE OF ALASKA AT ) ) ) Plaintiff, ) ) vs. ) ) ) ) CASE NO. CR Defendant. ) ) CONSENT TO TRIAL BY MAGISTRATE JUDGE I am the defendant in this case. I am appearing in this court before Magistrate Judge: . I have been charged with the crime(s) of: , in violation of . I have been informed that I have the right to trial before a District Court Judge. However, I hereby consent to be tried before a Magistrate Judge. Date Defendant's Signature Mailing Address City State ZIP Cell Phone Home Phone American LegalNet, Inc. www.FormsWorkFlow.com