COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : Index No. : Calendar No. UNITED STATES DISTRICT COURT JUDICIAL SUBPOENA FOR THE : Plaintiff(s) NORTHERN DISTRICT OF FLORIDA -against- : INSTRUCTIONS FOR FILING A PETITION FOR WRIT OF HABEAS CORPUS PURSUANT TO 28 U.S.C. § 2241 : Petitions under § 2241 will not be considered : the Court unless this by § 2241 petition form is completed as explained below. Defendant(s) : ...................................................... Explanation and Instructions - Read Carefully 1. This petition must be legibly handwritten or typewritten, and signed by the petitioner under the penalty of perjury. Any false statement OF material fact THE PEOPLE OF THE STATEof a NEW YORK may serve as the basis for prosecution for perjury. All questions must be answered concisely in the proper space on the form. TO The petition must be accompanied by a $5.00 filing fee or, if you are unable to pay the fee, a completed 2. application form seeking leave to proceed in forma pauperis. As explained on the application form, if either your average account balance or the average monthly deposits into your account is $25.00 or more, you will be unable to proceed in forma pauperis. GREETINGS: include all grounds for relief and a summary of the facts supporting each ground raised. You 3. You should must answer all questions in the proper space on the form. You may submit additional pages to explain the facts upon which you rely to support your grounds for relief. CAUTION: Any claim you and each of you or has before WE COMMAND YOU, that all business and excuses being laid aside, that may be brought attend already been brought by motion under 28 U.S.C. § 2255 will not be entertained by this Court unless it appears , the Honorable motion was or is inadequate or ineffective to test the legality of your detention. If you believe at the Court that the § 2255 located the County of case, you must explain why in at appropriate section of the petition form. this is the in room , on the day of , 20 , at o'clock in the noon, and at any recessed 4. No citation of authorities need be furnished. If a brief or additional argument is submitted, it should be orsubmitted indate,form of a separate memorandumaof law, not to exceed 25 pages in length absent prior leave adjourned the to testify and give evidence as witness in this action on the part of the of Court. 5. When the petition form is completed, the original must be filed with the Court along with a copy for each respondent, plus twoto comply with this subpoena is punishable as a contempt of court and will make you liable to Your failure additional copies for service upon the United States. the party petition andbehalf this subpoena wasmailed to one maximum penalty of $50 andwhichever is closer 6. The on whose all attachments must be issued for a of the addresses listed below, all damages sustained as a result of your failure toof incarceration: to your current place comply. Tallahassee Division Witness, Honorable Clerk, U.S District Court 111 N. Adams St. Court in County, Tallahassee, FL 32301-7717 Gainesville Division Clerk, U.S District Court 401 SE First Ave., Room 243 day of , 20 Gainesville, FL 32601 Pensacola OR Panama City Division , one of District Court Clerk, U.Sthe Justices of the 1 N. Palafox St., Room 226 Pensacola, FL 32502-5658 7. Petitioner is advised that respondent is not required to respond to the petition unless ordered by the Court and that default is inappropriate in habeas corpus proceedings. Once the Court has ordered a response and (Attorney must sign above and must also be counsel for respondent has appeared in the case, any documents you file with the Courttype name below)sent to counsel. All filings must include a certificate of service stating the date that a copy was served or mailed to counsel. 8. After receiving notice of your case number from the clerk, you must include the case number on all Attorney(s) for documents you file with the Court. You must keep a copy of every document you send to the Court as you are not entitled to free copies from the clerk even if you are proceeding in forma pauperis. You must immediately advise the Court of any change of address by filing a "Notice to the Court of Change of Address." This notice should contain the address change and the effective date and must be signed. FAILURE TO NOTIFY THE COURT OF ANY CHANGE OF ADDRESS COULD RESULT IN THE DISMISSAL OF YOUR Office and P.O. Address PETITION. Revised 07/02 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF FLORIDA JUDICIAL SUBPOENA Plaintiff(s) DIVISION -against- : : § 2241 HABEAS CORPUS PETITION FORM TO BE USED BY PRISONERS IN ACTIONS: UNDER 28 U.S.C. § 2241 OR IN ACTIONS CHALLENGING REMOVAL PROCEEDINGS Defendant(s) : ...................................................... THE PEOPLE OF THE STATE OF NEW YORK, . Inmate/Alien # TO GREETINGS: . WE COMMAND YOU, (Enter full name of Petitioner, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court prison number or alien [A] number, if applicable, located at County address of place of confinement.) of AND in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the vs. CASE NO: (To be assigned by Clerk) Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to , the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. , Witness, Honorable Court in County, , day of , , one of the Justices of the , 20 . (Enter name and title of each Respondent. (Attorney must sign above and type name below) If additional space is required, use the blank area below and directly to the right.) Attorney(s) for Office and P.O. Address ALL APPLICANTS MUST COMPLETE THIS ENTIRE FORM Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. : ANSWER ALL OF THE FOLLOWING: JUDICIAL SUBPOENA Plaintiff(s) 1. This petition concerns (check where applicable): -against(a). (b). (c). (d). (e). (f). G G G G G G : a conviction a sentence : prison disciplinary action or other action resulting in lost gain time credits parole : immigration/removal other (explain): Defendant(s) : ...................................................... 2. Provide the following information regarding the conviction(s) and sentence(s) for which you are presently incarcerated: (a). Name(s) and location(s) NEW YORK THE PEOPLE OF THE STATE OFof court: TO (b). Case Number(s): (c). Charge(s) for which you were convicted: GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before (d). What , the Honorable was your plea? (Check one) at the Court (1) Not Guilty G located at County of(2) Guilty G in room (3) Nolo ,contendere day of on the , 20 , at o'clock in the noon, and at any recessed G or adjourned date, to testify and give evidence as a witness in this action on the part of the (e). Did you appeal from the judgment of conviction? 3. Yes No G G If you did appeal, answer the following: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to (a) Name of Court: Case #: the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. (b) Result: Witness, Honorable (c) Date of opinion and mandate (citation, if known): Court in 4. County, day of , one of the Justices of the , 20 Claims that challenge your conviction or imposition of sentence can only be raised by motion under 28 U.S.C. § 2255 unless the § 2255 motion is inadequate (Attorney must sign test the legality of below) or ineffective to above and type name your detention. If any of the grounds raised above challenge your conviction or sentencing: (a) Have you filed a motion under 28 U.S.C. § 2255? Attorney(s) for Yes G No G If yes, please provide the case #, where filed, relevant date(s), and the results: Office and P.O. Address 2 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. (b). Explain why the remedy under § 2255 was or is inadequate or ineffective: : JUDICIAL SUBPOENA Plaintiff(s) -against- : : : Defendant(s) : ...................................................... 5. Are you currently represented by counsel in this case or in any other court case? Yes G No G If yes, please explain: THE PEOPLE OF THE STATE OF NEW YORK 6. TO If this case concerns removal proceedings: (a) Date of final order of removal: (b) Did you file an appeal with the Board of Immigration Appeals? Yes G No G 7. In the spaces below, set forth every ground which supports your claim that you are incarcerated GREETINGS: unlawfully. Briefly summarize the specific facts in support of each ground raised. Conclusions that are not supported by specific facts are insufficient. You may attach additional pages if necessary to raise WE COMMAND YOU, that all business not excuses being laid statement of facts. additional grounds or provide additional facts. Do and cite any law in your aside, you and each of you attend before , the Honorable at the Court located at County of (a). Ground one: in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a Supporting FACTS (state briefly without citing cases or law): result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 (Attorney must sign above and type name below) Exhaustion: Attorney(s) for [1] - Have you presented ground one to the Bureau of Prisons, either through the prison grievance system or other administrative proceeding? Yes G No G If yes, please provide the results of the proceeding(s) and the relevant date(s). Include any appeals: Office and P.O. Address 3 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. [2]-(Answer only if you are challenging an issue related to removal (immigration) proceedings) - Did : JUDICIAL SUBPOENAG you present ground one to the Board ofPlaintiff(s) Appeals? Immigration Yes G No If yes, please provide-against- of the proceeding(s) and the relevant date(s). the results : : (b). Ground two: : Defendant(s) : ...................................................... THE PEOPLE OFFACTS (state briefly without citing cases or law): Supporting THE STATE OF NEW YORK TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of Exhaustion: , on the in room day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the [1] - Have you presented ground two to the Bureau of Prisons, either through the prison grievance system or other administrative proceeding? Yes G No G If yes, please provide the results of the proceeding(s) and the relevant date(s). Include any appeals: liable to Your failure to comply with this subpoena is punishable as a contempt of court and will make you the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable , one of the Justices of the [2]-(Answer only if you are challenging an issue related to removal (immigration) proceedings) - Did Court in County, day of , 20 you present ground two to the Board of Immigration Appeals? Yes G No G If yes, please provide the results of the proceeding(s) and the relevant date(s). (Attorney must sign above and type name below) (c). Ground three: Attorney(s) for Office and P.O. Address 4 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Supporting FACTS (state briefly without citing cases or law):: Plaintiff(s) -against- Index No. Calendar No. JUDICIAL SUBPOENA : : : Defendant(s) : ...................................................... Exhaustion: [1] - Have you presented ground three to the Bureau of Prisons, either through the prison grievance THE PEOPLEor other administrative NEW YORK system OF THE STATE OF proceeding? Yes G No G TO If yes, please provide the results of the proceeding(s) and the relevant date(s). Include any appeals: GREETINGS: WE COMMAND YOU, that all business and excuses removal (immigration) proceedings) - attend before [2]-(Answer only if you are challenging an issue related to being laid aside, you and each of you Did , the Honorable at the you present ground three to the Board of Immigration Appeals? Court Yes G No G located at County of If in room yes, please on the the results of the proceeding(s) ,and the relevant date(s). , provide day of , 20 at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the (d). Ground four: Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Witness, Honorable Court in County, , one of the Justices of the day of , 20 Supporting FACTS (state briefly without citing cases or law): (Attorney must sign above and type name below) Attorney(s) for Office and P.O. Address Exhaustion: [1] - Have you presented ground four to the Bureau of Prisons, either through the prison grievance system or other administrative proceeding? Yes G No G 5 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : Index No. Calendar No. If yes, please provide the results of the proceeding(s) and the relevant date(s). Include any appeals: : JUDICIAL SUBPOENA Plaintiff(s) -against- : : [2]-(Answer only if you are challenging an issue related to removal (immigration) proceedings) - Did : you present ground four to the Board of Immigration Appeals? Yes G No G Defendant(s) : . . . . . .If. yes,.please .provide. the. results.of.the.proceeding(s) and.the relevant date(s). ... ..... ..... .. ..... . .. .............. .. 8. WHEREFORE, based upon the grounds raised above, Petitioner prays that the court will grant the THE PEOPLE OF THE STATE OF NEW YORK following relief: TO GREETINGS: WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before , the Honorable at the Court located at County of in room , on the day of , 20 , at o'clock in the noon, and at any recessed or adjourned date, to testify and give evidence as a witness in this action on the part of the DECLARATION I declare under penalty comply with this subpoena is punishable theainformationof court and will make you liable to Your failure to of perjury that I have read the above and as contempt contained herein is true and correct. the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. ________________________ (Date) Honorable Witness, Court in County, __________________________________________ Signature ,of PetitionerJustices of the one of the day of , 20 IF MAILED BY PRISONER: I declare or state under penalty of perjury that this petition(Attorney must one): was (check sign above and type name below) G delivered to prison officials for mailing, or G deposited in the prison’s internal mail system on: (date). Attorney(s) for __________________________________________ Office and P.O. Address Signature of Petitioner Revised 07/02 6 Telephone No.: Facsimile No.: E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com