AO 242 (12/11) Petition for a Writ of Habeas Corpus Under 28 U.S.C. § 2241 PETITION FOR A WRIT OF HABEAS CORPUS UNDER 28 U.S.C. § 2241 Instructions 1. Who Should Use This Form. You should use this form if · you are a federal prisoner and you wish to challenge the way your sentence is being carried out (for example, you claim that the Bureau of Prisons miscalculated your sentence or failed to properly award good time credits); · you are in federal or state custody because of something other than a judgment of conviction (for example, you are in pretrial detention or are awaiting extradition); or · you are alleging that you are illegally detained in immigration custody. Who Should Not Use This Form. You should not use this form if · you are challenging the validity of a federal judgment of conviction and sentence (these challenges are generally raised in a motion under 28 U.S.C. § 2255); · you are challenging the validity of a state judgment of conviction and sentence (these challenges are generally raised in a petition under 28 U.S.C. § 2254); or · you are challenging a final order of removal in an immigration case (these challenges are generally raised in a petition for review directly with a United States Court of Appeals). Preparing the Petition. The petition must be typed or neatly written, and you must sign and date it under penalty of perjury. A false statement may lead to prosecution. All questions must be answered clearly and concisely in the space on the form. If needed, you may attach additional pages or file a memorandum in support of the petition. If you attach additional pages, number the pages and identify which section of the petition is being continued. Note that some courts have page limitations. All filings must be submitted on paper sized 8½ by 11 inches. Do not use the back of any page. 4. Supporting Documents. In addition to your petition, you must send to the court a copy of the decisions you are challenging and a copy of any briefs or administrative remedy forms filed in your case. Required Filing Fee. You must include the $5 filing fee required by 28 U.S.C. § 1914(a). If you are unable to pay the filing fee, you must ask the court for permission to proceed in forma pauperis ­ that is, as a person who cannot pay the filing fee ­ by submitting the documents that the court requires. copies to the clerk of the United States Submitting Documents to the Court. Mail your petition and District Court for the district and division in which you are confined. For a list of districts and divisions, see 28 U.S.C. §§ 81-131. All copies must be identical to the original. Copies may be legibly handwritten. If you want a file-stamped copy of the petition, you must enclose an additional copy of the petition and ask the court to file-stamp it and return it to you. 7. Change of Address. You must immediately notify the court in writing of any change of address. If you do not, the court may dismiss your case. 2. 3. 5. 6. Page 1 of 10 American LegalNet, Inc. www.FormsWorkFlow.com AO 242 (12/11) Petition for a Writ of Habeas Corpus Under 28 U.S.C. § 2241 UNITED STATES DISTRICT COURT for the __________ District of __________ ) ) ) ) ) ) ) ) ) ) Petitioner v. Case No. (Supplied by Clerk of Court) Respondent (name of warden or authorized person having custody of petitioner) PETITION FOR A WRIT OF HABEAS CORPUS UNDER 28 U.S.C. § 2241 Personal Information 1. 2. (a) Your full name: (b) Other names you have used: Place of confinement: (a) Name of institution: (b) Address: (c) Your identification number: 3. Are you currently being held on orders by: Federal authorities 4. Are you currently: A pretrial detainee (waiting for trial on criminal charges) Serving a sentence (incarceration, parole, probation, etc.) after having been convicted of a crime If you are currently serving a sentence, provide: (a) Name and location of court that sentenced you: (b) Docket number of criminal case: (c) Date of sentencing: Being held on an immigration charge Other (explain): State authorities Other - explain: Page 2 of 10 American LegalNet, Inc. www.FormsWorkFlow.com AO 242 (12/11) Petition for a Writ of Habeas Corpus Under 28 U.S.C. § 2241 Decision or Action You Are Challenging 5. What are you challenging in this petition: How your sentence is being carried out, calculated, or credited by prison or parole authorities (for example, revocation or calculation of good time credits) Pretrial detention Immigration detention Detainer The validity of your conviction or sentence as imposed (for example, sentence beyond the statutory maximum or improperly calculated under the sentencing guidelines) Disciplinary proceedings Other (explain): 6. Provide more information about the decision or action you are challenging: (a) Name and location of the agency or court: (b) Docket number, case number, or opinion number: (c) Decision or action you are challenging (for disciplinary proceedings, specify the penalties imposed): (d) Date of the decision or action: Your Earlier Challenges of the Decision or Action 7. First appeal Did you appeal the decision, file a grievance, or seek an administrative remedy? Yes (a) If "Yes," provide: (1) Name of the authority, agency, or court: (2) Date of filing: (3) Docket number, case number, or opinion number: (4) Result: (5) Date of result: (6) Issues raised: No Page 3 of 10 American LegalNet, Inc. www.FormsWorkFlow.com AO 242 (12/11) Petition for a Writ of Habeas Corpus Under 28 U.S.C. § 2241 (b) If you answered "No," explain why you did not appeal: 8. Second appeal After the first appeal, did you file a second appeal to a higher authority, agency, or court? Yes (a) If "Yes," provide: (1) Name of the authority, agency, or court: (2) Date of filing: (3) Docket number, case number, or opinion number: (4) Result: (5) Date of result: (6) Issues raised: No (b) If you answered "No," explain why you did not file a second appeal: 9. Third appeal After the second appeal, did you file a third appeal to a higher authority, agency, or court? Yes (a) If "Yes," provide: (1) Name of the authority, agency, or court: (2) Date of filing: (3) Docket number, case number, or opinion number: (4) Result: (5) Date of result: (6) Issues raised: No Page 4 of 10 American LegalNet, Inc. www.FormsWorkFlow.com AO 242 (12/11) Petition for a Writ of Habeas Corpus Under 28 U.S.C. § 2241 (b) If you answered "No," explain why you did not file a third appeal: 10. Motion under 28 U.S.C. § 2255 In this petition, are you c