Application For Appointment Of Counsel Request For Stay Of Execution Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Application For Appointment Of Counsel Request For Stay Of Execution Form. This is a California form and can be use in USDC Northern Federal.
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Tags: Application For Appointment Of Counsel Request For Stay Of Execution, California Federal, USDC Northern
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UNITED STATES DISTRICT COURT
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NORTHERN DISTRICT OF CALIFORNIA
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(Full Name of Petitioner)
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Petitioner,
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CASE NO.
DEATH PENALTY CASE
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v.
(Name of Warden)
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Respondent.
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APPLICATION FOR
APPOINTMENT OF COUNSEL;
REQUEST FOR STAY OF
EXECUTION
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My name is
. I am a prisoner in state custody under
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sentence of death. I was convicted and sentenced in the
County
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Superior Court. The California Supreme Court affirmed my death sentence on
,
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. My scheduled execution date is
, 20
.
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I was tried and I am being held in violation of my federal constitutional rights. The
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attorney who represented me in my most recent state court proceeding in connection with my
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conviction and death sentence has informed me that he/she is unable to represent me in federal
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habeas corpus proceedings. I am indigent and have substantially no assets. I hereby request that
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the Court appoint an attorney to represent me in my habeas corpus case in this Court. I also
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request that the Court stay my execution at this time.
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I have filed the following federal applications for relief with respect to my conviction and
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death sentence:
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.
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I declare under penalty of perjury that the foregoing is true and correct.
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Dated:
[Signature of Prisoner]
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