UNITED STATES COURT OF APPEALS ELEVENTH CIRCUIT APPLICATION FOR LEAVE TO FILE A SECOND OR SUCCESSIVE MOTION TO VACATE, SET ASIDE OR CORRECT SENTENCE 28 U.S.C. § 2255 BY A PRISONER IN FEDERAL CUSTODY Name ______________________________________ Prisoner Number _________________________ Institution ____________________________________________________________________________ Street Address _________________________________________________________________________ City _______________________________ State _______________ Zip Code _____________ INSTRUCTIONS­READ CAREFULLY (1) This application must be legibly handwritten or typewritten and signed by the applicant under penalty of perjury. Any false statement of a material fact may serve as the basis for prosecution and conviction for perjury. All applicants seeking leave to file a second or successive motion to vacate should use this form. In capital cases, the use of this form is optional. All questions must be answered concisely in the proper space on the form. Additional pages are not permitted except with respect to identifying additional grounds for relief and facts on which you rely to support those grounds. To raise any additional claims, use the "Additional Claim" pages attached at the end of this application, which may be copied as necessary. DO NOT SUBMIT SEPARATE PETITIONS, MOTIONS, BRIEFS, ARGUMENTS, ETC., EXCEPT IN CAPITAL CASES. (2) (3) (4) 28 U.S.C. § 2255 Application Page 1 Revised: 2/17 American LegalNet, Inc. www.FormsWorkFlow.com (5) In accordance with the "Antiterrorism and Effective Death Penalty Act of 1996," as codified at 28 U.S.C. § 2255, effective April 24, 1996, before leave to file a second or successive motion can be granted by the United States Court of Appeals, it is the applicant's burden to make a prima facie showing that satisfies either of the two conditions in 28 U.S.C. § 2255(h), stated below. A second or successive motion must be certified as provided in [28 U.S.C.] section 2244 by a panel of the appropriate court of appeals to contain-- (1) newly discovered evidence that, if proven and viewed in light of the evidence as a whole, would be sufficient to establish by clear and convincing evidence that no reasonable factfinder would have found the movant guilty of the offense; or (2) a new rule of constitutional law, made retroactive to cases on collateral review by the Supreme Court, that was previously unavailable. (6) When this application is fully completed, the original and three copies must be mailed to: Clerk of Court United States Court of Appeals for the Eleventh Circuit 56 Forsyth Street, N.W. Atlanta, Georgia 30303 28 U.S.C. § 2255 Application Page 2 Revised: 2/17 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION 1. (a) Identify the United States District Court which entered the judgment of conviction being challenged: ___________________________________________________________________ ___________________________________________________________________ (b) Case number _______________________________________________________ 2. Date of judgment of conviction ______________________________________________ 3. Length of sentence ______________ Sentencing Judge ___________________________ 4. List all offenses for which you were convicted in the case identified above: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 5. Related to this conviction and sentence, have you ever filed a motion to vacate in any federal court? Yes ( ) No ( ) If "yes," how many times? __________________ (if more than one, complete 6 and 7 below as necessary) (a) Name of court _________________________________________________________ (b) Case number __________________________________________________________ (c) Nature of proceeding ____________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (d) Grounds raised (list all grounds; use extra pages if necessary)____________________ ________________________________________________________________________ ________________________________________________________________________ 28 U.S.C. § 2255 Application Page 3 Revised: 2/17 American LegalNet, Inc. www.FormsWorkFlow.com ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (e) Did you receive an evidentiary hearing on your motion? Yes ( ) No ( ) (f) Result ________________________________________________________________ ________________________________________________________________________ (g) Date of result __________________________________________________________ 6. As to any second federal motion, give the same information: (a) Name of court _________________________________________________________ (b) Case number __________________________________________________________ (c) Nature of proceeding __________________________________