UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT APPLICATION FOR LEAVE TO FILE A SECOND OR SUCCESSIVE MOTION TO VACATE, SET ASIDE OR CORRECT SENTENCE PURSUANT to 28 U.S.C. §§ 2244 (b), 2255(h) BY A PRISONER IN FEDERAL CUSTODY NAME: PRISONER NUMBER: PLACE OF CONFINEMENT: Instructions–Read Carefully (1) This application must be legibly handwritten or typewritten and signed by the applicant under penalty of perjury. All pleadings must be on 8½ x 11 inch paper; the Court will not accept other paper sizes. Any false statements of a material fact may serve as the basis for prosecution and conviction for perjury. (2) All questions must be answered concisely in the proper space on the form. (3) An applicant seeking leave to file a second or successive petition is required to use this form. (4) An applicant may use additional pages only to explain additional grounds for relief and facts that support those grounds. Separate petitions, motions, briefs, arguments, etc. should not be submitted. (5) In capital cases only, the use of this form is optional, and separate petitions, motions, briefs, arguments may be submitted. Application 28 USC 2244, 2255 Page 1 January 26, 2010 American LegalNet, Inc. www.FormsWorkFlow.com (6) An applicant must show in the motion to the Court of Appeals that the claim to be presented in a second or successive habeas corpus application is based upon either (1) (2 ) (7) newly discovered evidence that, if proven and viewed in light of the evidence as a whole, would be sufficient to establish by clear and convincing evidence that no reasonable fact finder would have found the movant guilty of the offense; or a new rule of constitutional law, made retroactive to cases on collateral review by the Supreme Court, that was previously unavailable. Send the completed application, the original and two copies, to: Clerk of Court United States Court of Appeals for the Second Circuit Thurgood Marshall United States Court House 40 Foley Square New York, New York 10007 Application 28 USC 2244, 2255 Page 2 January 26, 2010 American LegalNet, Inc. www.FormsWorkFlow.com APPLICATION 1. (a) (b) State and division of the United States District Court which entered the judgment of conviction under attack _____________________________________________ ___________________________________________________________________ Case number _______________________________________________________ 2. Date of judgment of conviction ______________________________________________ 3. Length of sentence ______________ Sentencing Judge ___________________________ 4. Nature of offense or offenses for which you were convicted:______________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 5. Have you taken a direct appeal relating to this conviction and sentence in the federal court? Yes ( ) No ( ) If "yes", please note below: (a) Name of court _________________________________________________________ (b) Case number __________________________________________________________ (c) Grounds raised (list all grounds; use extra pages if necessary) ____________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (d) Result ________________________________________________________________ (e) Date of result __________________________________________________________ 6. Related to this conviction and sentence, have you ever filed a motion to vacate in any federal court? 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)___________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Page 3 American LegalNet, Inc. www.FormsWorkFlow.com (e) Did you receive an evidentiary hearing on your motion? Yes ( ) No ( ) (f) Result ________________________________________________________________ ________________________________________________________________________ (g) Date of result __________________________________________________________ 7. As to any second federal motion, give the same information: (a) Name of court _________________________________________________________ (b) Case number __________________________________________________________ (c) Nature of proceeding ____________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (d) Grounds raised (list all grounds; use extra pages if necessary)___________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (e) Did you receive an evidentiary hearing on your motion? Yes ( ) No ( ) (f) Result ________________________________________________________________ ________________________________________________________________________ (g) Date of result __________________________________________________________ 8. As to any third federal motion, give the same information: (a) Name of court _________________________________________________________ (b) Case number __________________________________________________________ (c) Nature of proceeding ____________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (d) Grounds raised (list all grounds; use extra pages if necessary)___________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ (e) Did you receive an evidentiary hearing on your motion? Yes ( ) No ( ) (f) Result ________________________________________________________________ ________________________________________________________________________ (g) Date of result __________________________________________________________ 9. Did you appeal the result of any action taken on your federal motions? (Use extra pages to reflect additional federal motions if necessary) (1) First motion No ( ) Yes ( ) Appeal No. __________________ Page 4 American LegalNet, Inc. www.FormsWorkFlow.com (2) Second motion (3) Third motion No ( ) No ( ) Yes ( ) Appeal No. __________________ Yes ( ) Appeal No. __________________ 10. If you did not appeal from the adverse action on any motion, explain briefly why you did not: _____________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 11. State concisely every ground on which you now claim that you are being held unlawfully. Summarize briefly the facts supporting each ground. A. Ground one: _______________________________________________________ __________________________________________________________________ Supporting FACTS (tell your story briefly without citing cases or law): __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Was this claim raised in a prior motion? Yes ( ) No ( ) Does this claim rely on a "new rule of law?" Yes ( ) No ( ) If "yes," state the new rule of law (give case name and citation): __________________________________________________________________ __________________________________________________________________ Does this claim rely on "newly discovered evidence?" Yes ( ) No ( ) If "yes," briefly state the newly discovered evidence when it was discovered, and why it was not previously available to you. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ B. Ground two: _______________________________________________________ __________________________________________________________________ Supporting FACTS (tell your story briefly without citing cases or law): Page 5 American LegalNet, Inc. www.FormsWorkFlow.com __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ ________________________________________________________________ __________________________________________________________________ Was this claim raised in a prior motion? Yes ( ) No ( ) Does this claim rely on a "new rule of law?" Yes ( ) No ( ) If "yes," state the new rule of law (give case name and citation): __________________________________________________________________ ___________________________________________________________________ Does this claim rely on "newly discovered evidence?" Yes ( ) No ( ) If "yes," briefly state the newly discovered evidence when it was discovered, and why it was not previously available to you. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ [Additional grounds may be asserted on additional pages if necessary] 12. Do you have any motion or appeal now pending in any court as to the judgment now under attack? Yes ( ) No ( ) If "yes," name of court _________________________Case number___________________ Wherefore, applicant prays that the United States Court of Appeals for the Second Circuit grant an Order Authorizing the District Court to Consider Applicant's Second or Successive Motion to Vacate under 28 U.S.C. § 2255. ____________________________________ Applicant's Signature I declare under Penalty of Perjury that my answers to all the questions in this Application are true and correct. Executed on _______________________ [date] ____________________________________ Applicant's Signature Page 6 American LegalNet, Inc. www.FormsWorkFlow.com PROOF OF SERVICE Applicant must send a copy of this application and all attachments to the United States Attorney’s office in the district in which you were convicted. I certify that on ______________________________, I mailed a copy of this Application* and [date] all attachments to _________________________________________________________________ at the following address: ______________________________________________________________________________ ______________________________________________________________________________ ____________________________________ Applicant's Signature * Pursuant to Fed.R.App.P. 25(a), “Papers filed by an inmate confined in an institution are timely filed if deposited in the institution's internal mail system on or before the last day of filing. Timely filing of papers by an inmate confined in an institution may be shown by a notarized statement or declaration (in compliance with 28 U.S.C. § 174 6) setting forth the date o f deposit and stating that first-class postage ha s been prepaid.” Page 7 American LegalNet, Inc. www.FormsWorkFlow.com