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Petition For Writ Of Habeas Corpus Form. This is a California form and can be use in USDC Southern Federal.
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Tags: Petition For Writ Of Habeas Corpus, CIV-69, California Federal, USDC Southern
INSTRUCTIONS FOR FILING
PETITION UNDER 28 U.S.C. § 2241 FOR WRIT OF HABEAS CORPUS
IN THE UNITED STATES DISTRICT COURT
SOUTHERN DISTRICT OF CALIFORNIA
(1)
This petition must be legibly handwritten or typewritten, and signed by the petitioner under penalty
of perjury. Any false statement of a material fact may serve as the basis for prosecution and
conviction for perjury. All questions must be answered concisely in the proper space on the form.
Do NOT write on the back of any page.
(2)
Additional pages are not permitted except with respect to the facts which you rely upon to support
your grounds for relief. No citation of authorities need be furnished. If briefs or arguments are
submitted, they should be submitted in the form of a separate memorandum.
(3)
Upon receipt of a fee of $5 your petition will be filed if it is in proper order. The $5 fee must be
submitted with the petition, not separately.
(4)
If you do not have the necessary funds for transcripts, counsel, appeal, and other costs connected
with a motion of this type, you may request permission to proceed in forma pauperis, in which event
you must execute the form provided by the Court, setting forth information establishing your inability
to pay the costs. If you wish to proceed in forma pauperis, you MUST have an authorized officer at
the penal institution complete the certificate as to the amount of money and securities on deposit to
your credit in any account in the institution.
(5)
Only the execution of one sentence may be challenged in a single petition. If you seek to challenge
the execution of sentences in the same state or in different states, you must file separate petitions as
to each sentence.
(6)
You must include all grounds for relief and all facts supporting such grounds for relief in the petition
you file seeking relief from any execution of sentence.
(7)
When the petition is fully completed, the original and at least two copies must be mailed to: Clerk of
U.S. District Court, Room 4290, 880 Front Street, San Diego CA 92101-8900.
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2002 © American LegalNet, Inc.
NAME
PRISON NUMBER
PLACE OF CONFINEMENT
ADDRESS
United States District Court
Southern District Of California
,
(FULL NAME OF PETITIONER)
Civil No.
(TO BE FILLED IN BY CLERK OF U.S. DISTRICT COURT)
Petitioner
v.
,
PETITION FOR WRIT OF HABEAS CORPUS
(NAME OF WARDEN, SUPERINTENDENT, JAILOR, OR AUTHORIZED
PERSON HAVING CUSTODY OF PETITIONER, E.G. PAROLE OFFICER)
Respondent
UNDER 28 U.S.C. § 2241
and
The Attorney General of the State of
California, Additional Respondent.
1. Type of challenge (CHECK ONE):
“ Parole
“ Probation
“ Loss of good-time credits
“ Prison disciplinary hearing
“ Other (specify):
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2. Have you previously filed any petitions, applications, or motions with respect to the execution of your
sentence in any court, state or federal?
G Yes G No
3. If your answer to 2 was "Yes," give the following information:
(a)(1)
Name of court
(2)
Nature of proceeding
(3)
Grounds raised
(4)
Did you receive an evidentiary hearing on your petition, application or motion?
G Yes G No
(5)
(6)
(b)
Result
Date of result
As to any second petition, application or motion give the same information:
(1)
Name of court
(2)
Nature of proceeding
(3)
Grounds raised
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(4)
Did you receive an evidentiary hearing on your petition, application or motion?
G Yes G No
(5)
Result
(6)
Date of result
(c) Did you appeal, to the highest state court having jurisdiction, the result of action taken on any
petition, application or motion?
(1) First petition, etc.
G Yes G No
(2) Second petition, etc. G Yes G No
(d)
If you did not appeal from the adverse action on any petition, application or motion, explain
briefly why you did not:
4. State concisely every ground on which you claim that you are being held in violation of the
constitution, law or treaties of the United States. Summarize briefly the facts supporting each
ground. If necessary, you may attach pages stating additional grounds and facts supporting same.
CAUTION: In order to proceed in the federal court, you must ordinarily first exhaust your
available state court remedies as to each ground on which you request action by the
federal court. Moreover, if you fail to set forth all grounds in this petition, you may
be barred from presenting additional grounds at a later date.
You should raise in this petition all available grounds on which you base your allegations that you
are being held in custody unlawfully.
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A.
Ground one:
Supporting FACTS (state briefly without citing cases or law)
B. Ground two:
Supporting FACTS (state briefly without citing cases or law):
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C.
Ground three:
Supporting FACTS (state briefly without citing cases or law):
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D. Ground four:
Supporting FACTS (state briefly without citing cases or law):
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5. If any of the grounds listed in 4A, B, C, and D were not previously presented in any other court, state
or federal, state briefly what grounds were not presented, and give your reasons for not presenting
them:
6. Do you have any petition or appeal now pending in any court, either state or federal, as to the execution
of sentence under attack?
G Yes G No
7. Give the name and address, if known, of each attorney who represented you in the following stages of
the execution of sentence attacked herein:
(a)
In any post-conviction proceeding
(b)
On appeal from any adverse ruling in a post-conviction proceeding
Wherefore, petitioner prays that the Court grant petitioner relief to which he may be entitled in this
proceeding.
SIGNATURE OF ATTORNEY (IF ANY)
I declare under penalty of perjury that the foregoing is true and correct. Executed on
(DATE)
SIGNATURE OF PETITIONER
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FORM D
PROOF OF SERVICE
BY A PERSON
IN STATE CUSTODY
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PROOF OF SERVICE BY MAIL
BY PERSON IN STATE CUSTODY
(Fed. R. Civ. P. 5; 28 U.S.C. § 1746)
I, _______________________________________________________________________, declare:
I am over 18 years of age and a party to this action. I am a resident of ____________________________
_______________________________________________________________________________Prison,
in the county of _______________________________________________________________________,
State of California. My prison address is: __________________________________________________,
____________________________________________________________________________________.
On_____________________________________________________________________________,
(DATE)
I served the attached: ___________________________________________________________________
_____________________________________________________________________________________
(DESCRIBE DOCUMENT)
on the parties herein by placing true and correct copies thereof, enclosed in a sealed envelope, with postage
thereon fully paid, in the United States Mail in a deposit box so provided at the above-named correctional
institution in which I am presently confined. The envelope was addressed as follows:
_____________________________________________________________________________________
_____________________________________________________________________________________
I declare under penalty of perjury under the laws of the United States of America that the foregoing
is true and correct.
Executed on ___________________
(DATE)
______________________________________________
(DECLARANT’S SIGNATURE)
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