UNITED STATES COURT OF APPEALS ELEVENTH CIRCUIT APPLICATION FOR LEAVE TO FILE A SECOND OR SUCCESSIVE HABEAS CORPUS PETITION 28 U.S.C. § 2244(b) BY A PRISONER IN STATE CUSTODY Name ______________________________________ Prisoner Number _________________________ Institution ____________________________________________________________________________ Street Address ___________________________________________________________________________ City _______________________________ State _______________ Zip Code _____________ INSTRUCTIONS­READ CAREFULLY (1) This application must be legibly handwritten or typewritten and signed by the applicant under penalty of perjury. Any false statement of a material fact may serve as the basis for prosecution and conviction for perjury. All applicants seeking leave to file a second or successive petition should use this form. In capital cases, the use of this form is optional. All questions must be answered concisely in the proper space on the form. Additional pages are not permitted except with respect to identifying additional grounds for relief and facts on which you rely to support those grounds. To raise any additional claims, use the "Additional Claim" pages attached at the end of this application, which may be copied as necessary. DO NOT SUBMIT SEPARATE PETITIONS, MOTIONS, BRIEFS, ARGUMENTS, ETC., EXCEPT IN CAPITAL CASES. (2) (3) (4) 28 U.S.C. § 2244(b) Application Page 1 Revised: 2/17 American LegalNet, Inc. www.FormsWorkFlow.com (5) In accordance with the "Antiterrorism and Effective Death Penalty Act of 1996," as codified at 28 U.S.C. § 2244(b), effective April 24, 1996, before leave to file a second or successive petition can be granted by the United States Court of Appeals, it is the applicant's burden to make a prima facie showing that satisfies the conditions in 28 U.S.C. § 2244(b), stated below. (b)(1) a claim presented in a second or successive habeas corpus application under [28 U.S.C.] section 2254 that was presented in a prior application shall be dismissed. (2) a claim presented in a second or successive habeas corpus application under [28 U.S.C.] section 2254 that was not presented in a prior application shall be dismissed unless-- (A) the applicant shows that the claim relies on a new rule of constitutional law, made retroactive to cases on collateral review by the Supreme Court, that was previously unavailable; or (B)(i) the factual predicate for the claim could not have been discovered previously through the exercise of due diligence; and (ii) the facts underlying the claim, if proven and viewed in light of the evidence as a whole, would be sufficient to establish by clear and convincing evidence that, but for constitutional error, no reasonable factfinder would have found the applicant guilty of the underlying offense. (6) When this application is fully completed, the original and three copies must be mailed to: Clerk of Court United States Court of Appeals for the Eleventh Circuit 56 Forsyth Street, N.W. Atlanta, Georgia 30303 28 U.S.C. § 2244(b) Application Page 2 Revised: 2/17 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION 1. (a) Identify the court which entered the judgment of conviction being challenged: ___________________________________________________________________ ___________________________________________________________________ (b) Case number _______________________________________________________ 2. Date of judgment of conviction ______________________________________________ 3. Length of sentence ______________ Sentencing Judge ___________________________ 4. List all offenses for which you were convicted in the case identified above: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 5. Have you ever filed a post-conviction petition, application, or motion for collateral relief in any federal court related to this conviction and sentence? Yes ( ) No ( ) If "yes," how many times? __________________ (if more than one, complete 6 and 7 below as necessary) (a) Name of court _________________________________________________________ (b) Case number __________________________________________________________ (c) Nature of proceeding ____________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (d) Grounds raised (list all grounds; use extra pages if necessary)____________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 28 U.S.C. § 2244(b) Application Page 3 Revised: 2/17 American LegalNet, Inc. www.FormsWorkFlow.com ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (e) Did you receive an evidentiary hearing on your petition, application, or motion? Yes ( ) No ( ) (f) Result ___________________________________________