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The United States District Court and the district, the case name United States of America v. the defendant, and the case number.
AO 86A
Consent to Proceed Before a Magistrate Judge in a Misdemeanor Case
AO 86A, Consent to Proceed Before a Magistrate Judge in a Misdemeanor Case, is a U.S. Courts form for a criminal case in a United States district court, captioned United States of America v. the defendant. The U.S. Courts page lists it under Defendant Consent and Waiver Forms, effective on January 1, 2009, and the form is marked Rev. 01/09.
On the one-page form, the defendant states that a United States magistrate judge has explained the nature of the charges, the maximum penalty for each charge, and the rights to a lawyer, to a jury trial, and to be tried, judged and sentenced before either a district judge or a magistrate judge. It then has a consent to trial before a magistrate judge and two separate waivers, one of a jury trial and one of 30 days to prepare for trial. A magistrate judge signs to approve it.
This page explains the form in plain words and is not legal advice. The form is signed in the case by the defendant, a government representative, the defendant's attorney if any, and the magistrate judge. You can fill out the blank form free in your browser on this page and download it without an account.

The United States District Court and the district, the case name United States of America v. the defendant, and the case number.
The defendant states what the magistrate judge explained, then: "I consent to being tried before a United States magistrate judge, and I waive my rights to trial, judgment, and sentencing by a United States district judge."

One line reads "I waive my right to a jury trial," followed by the defendant's signature and the government representative's consent to the jury-trial waiver.
Under the heading Waiver of a Right to Have 30 Days to Prepare for Trial, one line reads "I waive my right to have 30 days to prepare for trial," with a defendant's signature line.
The printed name and signature of the defendant's attorney (if any), a date, and the Approved by line for the magistrate judge's signature.
Enter the district, the defendant's name in the United States of America v. caption, and the case number.
The first paragraph records that a magistrate judge explained the charges, the maximum penalty for each charge, and the rights to a lawyer, to a jury trial, and to a district judge or magistrate judge.
The defendant's signature line sits right below the consent to be tried before a United States magistrate judge.
Each waiver has its own heading and its own defendant's signature line. The jury-trial waiver also has lines for the government representative's consent, printed name and title.
The defendant's attorney, if any, prints a name and signs. The form ends with the date and the magistrate judge's signature on the Approved by line.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The form is captioned for a United States District Court, in a criminal case titled United States of America v. the defendant, with a case number.
The form and its U.S. Courts page do not print a fee.
The form ends with a date and an Approved by line for the magistrate judge's signature.
The U.S. Courts page offers AO 86A as a PDF download. The PDF has Print, Save As and Reset buttons.
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The defendant signs below the consent paragraph, and again under each waiver heading: once for the jury-trial waiver and once for the waiver of 30 days to prepare for trial.
The form says a United States magistrate judge explained the charges, the maximum penalty and the defendant's rights. At the bottom, the magistrate judge signs the Approved by line next to the date.
Under the jury-trial waiver, the form reads "The United States consents to the jury-trial waiver" and has lines for the government representative's signature, printed name and title.
Near the bottom are lines for the printed name and the signature of the defendant's attorney, each marked "(if any)".
The form has signature lines for four people. It is not a form a member of the public files on their own.
The agency’s own page for Form AO 86A.
The official blank form, to print or fill by hand.
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The form has lines for the defendant's signature (under the consent and under each waiver), the government representative's signature, printed name and title, the defendant's attorney's printed name and signature (if any), and the magistrate judge's signature on the Approved by line.
The nature of the charges, the maximum penalty that may be imposed on each charge if the defendant is found guilty, and the rights to a lawyer, to a jury trial, and to be tried, judged and sentenced before either a United States district judge or a United States magistrate judge.
On the form it is a separate section. Waiver of a Right to Trial by Jury has its own heading, its own defendant's signature line, and lines for the government representative to consent to the jury-trial waiver.
The last waiver section reads "I waive my right to have 30 days to prepare for trial" and has its own defendant's signature line.
No. Neither the form nor its U.S. Courts page prints a fee.
No. This page explains what the form says in plain words. It does not say whether anyone should sign the consent or any waiver.