PETITION UNDER 28 U.S.C. 247 2254 FOR WRIT OF HABEAS CORPUS BY A PERSON IN STATE CUSTODY UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MISSOURI DIVISION Name (under which you were convicted): Docket or Case No.: Place of Confinement: Prisoner No . : Petitioner: (include the name under which you were convicted): Respondent: (authorized person having custody of petitioner): 1.(a) Name and location of court that entered the judgment of conviction you are challenging: (b) Criminal docket or case number (if you know): 2.(a) Date of the judgment of conviction (if you know): (b) Date of sentencing: 3.Length of sentence: 4.In this case, were you convicted of more than one count or of more than one crime? Yes No 5. Identify all crimes which you were convicted and sentenced in this case: 6.(a) What was your plea? (Check one) (1) Not guilty (3) Nolo contendere (no contest) (2) Guilty (4) Insanity plea (b) If you entered a guilty plea to one count or charge and a not guilty plea to another count or charge, what did you plead guilty to and what did you plead not guilty to? (c) If you went to trial, what kind of trial did you have? (Check one) Jury Judge only 7.Did you testify at a pretrial hearing, trial, or a post-trial hearing? Yes No American LegalNet, Inc. www.FormsWorkFlow.com 8.Did you appeal from the judgment of conviction? Yes No 9.If you did appeal, answer the following: (a) Name of court: (b) Docket or case number (if you know): (c) Result: (d) Date of result (if you know): (e)Citation to the case (if you know): (f) Grounds raised:(g) Did you seek further review by a higher state court? Yes NoIf yes, answer the following: (1) Name of court: (2) Docket or case number (if you know): (3) Result: (4) Date of result (if you know): (5) Citation to the case (if you know): (6) Grounds raised: (h) Did you file a petition for certiorari in the United States Supreme Court? Yes No If yes, answer the following: (1) Docket or case number (if you know): (2) Result: (3) Date of result (if you know): (4) Citation to the case (if you know): 10.Other than the direct appeals listed above, have you previously filed any other petitions, applications, ormotions concerning the judgment of conviction in any state court? Yes No11.If you answer to Question was 223Yes,224 give the following information:(a) (1) Name of court: American LegalNet, Inc. www.FormsWorkFlow.com (2) Docket or case number (if you know): (3) Date of filing (if you know): (4) Nature of the proceeding: (5) Grounds raised: (6) Did you receive a hearing where evidence was given on your petition, application, or motion? Yes No (7) Result: (8) Date of result (if you know): (b) If you filed any second petition, application, or motion, give the same information: (1) Name of court: (2) Docket or case number (if you know): (3) Date of filing (if you know): (4) Nature of the proceeding: (5) Grounds raised:(6) Did you receive a hearing where evidence was given on your petition, application, or motion? Yes No (7) Result: (8) Date of result (if you know): (c) If you filed any third petition, application, or motion, give the same information: (1) Name of court: (2) Docket or case number (if you know): (3) Date of filing (if you know): (4) Nature of the proceeding: (5) Grounds raised:(6) Did you receive a hearing where evidence was given on your petition, application, or motion? American LegalNet, Inc. www.FormsWorkFlow.com Yes No (7) Result: (8) Date of result (if you know): (d) Did you appeal to the highest state court having jurisdiction over the action on your petition, application, or motion? (1) First petition: Yes No (2) Second petition: Yes No (3) Third petition: Yes No (e) If you did not appeal to the highest state court having jurisdiction, explain why you did not: 12.For this petition, state every ground on which you claim that you are being held in violation of theConstitution, laws, or treaties of the United States. Attach additional pages if you have more than fourgrounds. State the facts supporting each ground. Any legal arguments must be submitted in a separatememorandum. CAUTION: To proceed in the federal court, you must ordinarily first exhaust (use up) your availablestate-court remedies on each ground on which you request action by the federal court. Also, if youfail to set forth all the grounds in this petition, you may be barred from presenting additionalgrounds at a later date. GROUND ONE: (a) Supporting facts. Do not argue or cite law. Just state the specific facts that support your claim:(b) If you did not exhaust your state remedies on Ground One, explain why:(c) Direct Appeal of Ground One: (1) If you appealed from the judgment of conviction, did you raise the issue? Yes No (2) If you did not raise this issue in your direct appeal, explain why: American LegalNet, Inc. www.FormsWorkFlow.com (d) Post-Conviction Proceedings: (1) Did you raise this issue through a post-conviction motion or petition for habeas corpus in a state trial court? Yes No (2) If your answer to Question (d)(1) is 223Yes,224 state: Type of motion or petition: Name and location of the court where the motion or petition was filed:Docket or case number (if you know): Date of court222s decision: Result (attach a copy of the court222s opinion or order, if available):(3) Did you receive a hearing on your motion or petition? Yes No (4) Did you appeal from the denial of your motion or petition? Yes No (5) If your answer to Question (d)(4) is 223Yes,224 did you raise this issue in the appeal? Yes No (6) If your answer to Question (d)(4) is 223Yes,224 state: Name and location of the court where the appeal was filed:Docket or case number (if you know): Date of the court222s decision: Result (attach a copy of the court222s opinion or order, if available):(7) If your answer to Question (d)(4) or Question (d)(5) is 223No,224 explain why you did not raise this issue:(e) Other Remedies: Describe any other procedures (such as habeas corpus, administrative remedies, etc.) that you have used to exhaust your state remedies on Ground One: American LegalNet, Inc. www.FormsWorkFlow.com GROUND TWO: (a) Supporting facts. Do not argue or cite law. Just state the specific facts that support your claim:(b) If you did not exhaust your state remedies on Ground Two, explain why:(c) Direct Appeal of Ground Two: (1) If you appealed from the judgment of conviction, did you raise the issue? Yes No (2) If you did not raise this issue in your direct appeal, explain why: (d) Post-Conviction Proceedings: (1) Did you raise this issue through a post-conviction motion or petition for habeas corpus in a state trial court? Yes No (2) If your answer to Question (d)(1) is 223Yes,224 state: Type of motion or petition: Name and location of the court where the motion or petition was filed:Docket or case number (if you know): Date of court222s decision: Result (attach a copy of the court222s opinion or order, if available):(3) Did you receive a hearing on your motion or petition? Yes No (4) Did you appeal from the denial of your motion or petition? Yes No American LegalNet, Inc. www.FormsWorkFlow.com (5) If your answer to Question (d)(4) is 223Yes,224 did you raise this issue in the appeal? Yes No (6) If your answer to Question (d)(4) is 223Yes,224 state: Name and location of the court where the appeal was filed:Docket or case number (if you know): Date of the court222s decision: Result (attach a copy of the court222s opinion or order, if available):(7) If your answer to Question (d)(4) or Question (d)(5) is 223No,224 explain why you did not raise this issue:(e) Other Remedies: Describe any other procedures (such as habeas corpus, administrative remedies, etc.) that you have used to exhaust your state remedies on Ground Two: GROUND THREE: (a) Supporting facts. Do not argue or cite law. Just state the specific facts that support your claim:(b) If you did not exhaust your state remedies on Ground Three, explain why:(c) Direct Appeal of Ground Three: (1) If you appealed from the judgment of conviction, did you raise the issue? Yes No (2) If you did not raise this issue in your direct appeal, explain why: American LegalNet, Inc. www.FormsWorkFlow.com (d) Post-Convic