CERTIFICATE OF DEATH PENALTY CASE Fourth Circuit Local Rule 22(b) U.S. District Court for the Case Caption: Counsel for Petitioner/Defendant (name, address, phone) Counsel for Respondent/Plaintiff: (name, address, phone) Institution of Incarceration: Explanation of Emergency Nature of Proceedings Has petitioner/defendant previously filed cases in federal court? [ ] No [ ] Yes (give court, caption, number, filing date, disposition and disposition date) Does petitioner/defendant have cases pending in other courts? [ ] No [ ] Yes (give court, caption, number, filing date and status) I hereby certify under penalty of perjury that the petitioner/defendant is presently under a sentence of death and that the information provided on this form is currently accurate and correct. Date Note: Signature The Court of Appeals will periodically request case status reports. Counsel is under a continuing affirmative obligation to immediately notify the Fourth Circuit of any changes or additions to the information contained on this form. In cases with a pending execution date, counsel must provide the Court of Appeals with four copies of all documents filed in the U.S. District Court and any pertinent state court materials. 2000 (C) American LegalNet, Inc.