UNITED STATES DISTRICT COURTEASTERN DISTRICT OF VIRGINIA DIVISIONUNITED STATES OF AMERICAv.CONSENT TO PROCEED BEFORE UNITEDSTATES MAGISTRATE JUDGE IN AMISDEMEANOR CASECASE NUMBER:The United States magistrate judge has informed me of the nature of the offense(s) with which I am charged and themaximum possible penalties which might be imposed if I am found guilty. The magistrate judge has informed me ofmy right to the assistance of legal counsel. The magistrate judge has informed me of my right to trial, judgment, andsentencing before a United States district judge.I hereby waive (give up) my right to trial, judgment, and sentencing before a United States district judge, andconsent to trial, judgment and sentencing before a United States magistrate judge.X Date DefendantWAIVER OF RIGHT TO TRIAL BY JURYThe magistrate judge has informed me of my right to trial by jury.I hereby waive (give up) my right to trial by jury.X DefendantConsented to by the United States: Signature of Ass22t. U.S. AttorneyApproved By: U.S. Magistrate Judge WAIVER OF RIGHT TO COUNSELThe magistrate judge has informed me of my right to the assignment of counsel if I am unable to obtain counsel.I hereby waive (give up) my right to counsel and choose to proceed without a lawyer.X DefendantWAIVER OF RIGHT TO HAVE THIRTY DAYS TO PREPARE FOR TRIALThe magistrate judge has informed me of my right to have at least thirty days to prepare for trial before the magistratejudge.I hereby waive (give up) my right to have at least thirty days to prepare for trial.X Defendant American LegalNet, Inc. www.FormsWorkFlow.com