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Petition For A Writ Of Habeas Corpus By A Person In Custody Form. This is a District Of Columbia form and can be use in USDC-District of Columbia Federal.
Tags: Petition For A Writ Of Habeas Corpus By A Person In Custody, District Of Columbia Federal, USDC-District of Columbia
R ev. 7/06
C O Hab C orp
AO 241 amd.
Page 1
UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF COLUMBIA
__________________________________________
NAME (Under which you were convicted)
__________________________________________
PRISON NUMBER
__________________________________________
PLACE OF CONFINEMENT/ADDRESS
__________________________________________
__________________________________________
__________________________________________
__________________________________________)
(Full Name)
Petitioner
)
)
)
v.
)
)
)
__________________________________________)
(Name of Warden, Superintendent, Jailor, or
)
authorized person having custody of petitioner)
)
Respondent
)
Civil Action No.: _______________
(To be filled in by Clerk)
PETITION FOR WRIT OF HABEAS CORPUS
BY A PERSON IN CUSTODY IN THE DISTRICT OF COLUMBIA
INSTRUCTIONS - PLEASE READ CAREFULLY
1.
This petition must be legibly handwritten or typed, and signed by the petitioner. Any false
statement of 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.
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, your petition will be filed if it is in proper order and is accompanied by a $5.00 filing
fee. Your check or money order should be made payable to: Clerk, U.S. District Court.
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4.
If you cannot afford to pay the filing fee, you may request permission to proceed in forma pauperis,
in which event you must execute the affidavit on the last page, 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 sentences imposed by one court may be challenged in a single petition. If you seek to
challenge sentences entered by different courts, you must file separate petitions as to each court.
6.
When you have completed the form, send the original and one copy to:
Clerk, United States District Court for the District of Columbia
Room 1225
333 Constitution Avenue, NW
Washington, DC 20001
7.
Petitions which do not conform to these instructions may be returned with a notation as to the
deficiency.
PETITION
1.
(a)
Name and location of court which imposed the sentence (or detention) of conviction you
are challenging:
_____________________________________________________________________
______________________________________________________________________
______________________________________________________________________
2.
(a)
Date of the sentence (or detention): _________________________________________
3.
Length of sentence: ____________________________________________________________
____________________________________________________________________________
4.
Nature of offense involved (all counts): ____________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_____________________________________________________________________________
5.
(a)
What was your plea? (Check one):
Not guilty
Guilty
Nolo Contendere (no contest)
Insanity
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(b)
If you entered a guilty plea to one count or charge, and a not guilty plea to another count
or charge, give details: ______________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
______________________________________________________________________
6.
Have you previously filed any petitions, applications, or motions with respect to this sentence in
any court?
Yes
No
7.
If your answer to Question 10 was “Yes,” give the following information:
(a)
(1)
Name of Court: ___________________________________________________
(2)
Nature of the proceedings: __________________________________________
________________________________________________________________
_______________________________________________________________
_________________________________________________________________
(3)
Grounds raised: ___________________________________________________
________________________________________________________________
_______________________________________________________________
_______________________________________________________________
__________________________________________________________________
(4)
Did you receive an evidentiary hearing on your petition, application or motion?
Yes
No
(5)
Result: __________________________________________________________
(6)
Date of result: ____________________________________________________
(b)
As to any second petition, application, or motion, give the same information:
(1)
Name of Court: ___________________________________________________
(2)
Nature of the proceedings: __________________________________________
________________________________________________________________
_______________________________________________________________
_________________________________________________________________
(3)
Grounds raised: ___________________________________________________
________________________________________________________________
_______________________________________________________________
_______________________________________________________________
__________________________________________________________________
(4)
Did you receive an evidentiary hearing on your petition, application or motion?
Yes
No
(5)
Result: __________________________________________________________
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(6)
Date of result: ____________________________________________________
(c)
As to any third petition, application, or motion, give the same information:
(1)
Name of Court: ___________________________________________________
(2)
Nature of the proceedings: __________________________________________
________________________________________________________________
_______________________________________________________________
_________________________________________________________________
(3)
Grounds raised: ___________________________________________________
________________________________________________________________
_______________________________________________________________
_______________________________________________________________
__________________________________________________________________
(4)
Did you receive an evidentiary hearing on your petition, application or motion?
Yes
No
(5)
Result: __________________________________________________________
(6)
Date of result: ____________________________________________________
(d)
Did you appeal to the highest court having jurisdiction for the result of action taken in any
petition, application or motion?
(1)
First petition, etc.”
Yes
No
(2)
Second petition, etc.:
Yes
No
(3)
(e)
8.
Third petition, etc.:
Yes
No
If you did not appeal from the adverse action on any petition, application, or motion,
explain briefly why you did not: ____________________________________________
______________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
State concisely every ground on which you claim that you are being held unlawfully. Summarize
briefly the facts supporting each ground. If necessary, you may attach pages stating additional
grounds and facts supporting same.
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A.
GROUND ONE:
(a)
Supporting FACTS (Do not argue or cite law. Just state the specific facts that support your
claim: ____________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
B.
GROUND TWO:
(a)
Supporting FACTS (Do not argue or cite law. Just state the specific facts that support your
claim: ____________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
C.
GROUND THREE:
(a)
Supporting FACTS (Do not argue or cite law. Just state the specific facts that support your
claim: ____________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
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D.
GROUND FOUR:
(a)
Supporting FACTS (Do not argue or cite law. Just state the specific facts that support your
claim: ____________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_______________________________________________________________________
9.
If any of the grounds listed in 8A, B, C, or D were not previously presented in any other court,
District of Columbia or Federal, state briefly what grounds were not so presented, and give your
reasons for not presenting them: _____________________________________________
____________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
_____________________________________________________________________________
10.
Do you have any petition or appeal pending in any other court, either, District of Columbia or
Federal, as to the sentence (or detention) under attack?
Yes
No
(a)
11.
If so, give the name and location of the court and case number, if known: ___________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Do you have any future sentence to serve after you complete the sentence (or detention) under
attack?
Yes
No
(a)
If so, give name and location of court which imposed sentence to be served in the future:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
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(b)
(c)
And give date and length of sentence to be served in future: ______________________
______________________________________________________________________
Have you filed, or do you contemplate filing, any petition attacking the judgment which
imposed the sentence to be served in the future?
Yes
No
Wherefore, petitioner prays that the Court grant petitioner relief to which he may be entitled in
this proceeding.
___________________________________
Petitioner’s Signature
__________________
Date
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