IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF TEXAS MOTION UNDER 28 U.S.C. SECTION 2255, TO VACATE, SET ASIDE, OR CORRECT SENTENCE BY A PERSON IN FEDERAL CUSTODY UNITED STATES OF AMERICA PLACE OF CONFINEMENT vs. PRISONER ID NUMBER MOVANT (full name of movant) CRIMINAL CASE NUMBER (If a movant has a sentence to be served in the future under a federal judgment which he wishes to attack, he should file a motion in the federal court which entered the judgment.) INSTRUCTIONS - READ CAREFULLY 1. This motion must be legibly handwritten or typewritten, and signed by the movant under penalty of perjury. Any false statement of a material fact may serve as the basis for prosecution and conviction for perjury. All questions must be answered concisely in the proper space on the form. 2. Additional pages are not permitted except with respect to the facts which you rely upon to support your grounds for relief. No citation of authorities needs to be furnished. If briefs or arguments are submitted, they should be submitted in the form of a separate memorandum. 3. Upon receipt, your motion will be filed if it is in proper order. No fee is required with this motion. American LegalNet, Inc. www.FormsWorkflow.com Page 2 of 10 4. If you do not have the necessary funds for transcripts, counsel, appeal, and other costs connected with a motion of this type, you may request permission to proceed in forma pauperis, in which event you must execute the declaration provided with this motion, setting forth information establishing your inability to prepay the fees and costs or give security therefor. If you wish to proceed in forma pauperis, you must have an authorized officer at the penal institution complete the certificate as to the amount of money and securities on deposit to your credit in any account in the institution. 5. Only judgments entered by one court may be challenged in a single motion. If you seek to challenge judgments entered by different judges or divisions either in the same district or in different districts, you must file separate motions as to each such judgment. 6. Your attention is directed to the fact that you must include all grounds for relief and all facts supporting such grounds for relief in the motion you file seeking relief from any judgment of conviction. 7. When the motion is fully completed, the original and two copies must be mailed to the Clerk of the United States District Court for the Northern District of Texas at the appropriate divisional office whose address is: Abilene Division P.O. Box 1218 Abilene, TX 79604 Amarillo Division 205 E. 5th St, Rm 133 Amarillo, TX 79101 Lubbock Division 1205 Texas Ave., Rm 209 Lubbock, TX 79401 8. Dallas Division 1100 Commerce, Rm 1452 Dallas, TX 75242 San Angelo Division 33 East Twohig St, Rm 202 San Angelo, TX 76903 Fort Worth Division 501 W. 10th St, Rm 310 Fort Worth, TX 76102 Wichita Falls Division P.O. Box 1234 Wichita Falls, TX 76307 Motions which do not conform to these instructions will be returned with a notation as to the deficiency. American LegalNet, Inc. www.FormsWorkflow.com Page 3 of 10 MOTION 1. Name and location of court that entered the judgment of conviction you are challenging: 2. Date of the judgment of conviction: 3. Length of sentence: 4. Nature of offense involved (all counts): 5. (a) What was your plea? (Check one) Not guilty Guilty Nolo contendere (no contest) (b) If you entered a guilty plea to one count or indictment, and a not guilty plea to another count or or indictment, what did you plead guilty to and what did you plead not guilty to? 6. If you went to trial, what kind of trial did you have? (Check one) 7. Did you testify at the trial? (Check one) 8. Did you appeal from the judgment of conviction? (Check one) Jury Yes Yes Judge Only No No 9. If you did appeal, answer the following: Name of Court: Result: Date of result: American LegalNet, Inc. www.FormsWorkflow.com Page 4 of 10 10. Other than a direct appeal from the judgment of conviction and sentence, have you previously filed any petitions, applications, or motions with respect to this judgment in any federal court? No Yes 11. If your answer to 10 was "Yes" give the following information: Name of Court: Nature of proceeding: Grounds raised: Did you receive an evidentiary hearing on your petition, application or motion? Yes No Result: Date of result: As to any second petition, application or motion, give the same information: Name of Court: Nature of proceeding: Grounds raised: Did you receive an evidentiary hearing on your petition, application or motion? Yes No Result: Date of result: American LegalNet, Inc. www.FormsWorkflow.com Page 5 of 10 As to any third petition, application or motion, give the same information: Name of Court: Nature of proceeding: Grounds raised: Did you receive an evidentiary hearing on your petition, application or motion? Yes No Result: Date of result: Did you appeal to an appellate federal court having jurisdiction, the result of action taken on any petition, application or motion? First petition, etc. Second petition, etc. Third petition, etc. Yes Yes No No Yes No If you did not appeal from the adverse action on any petition, application or motion, explain briefly why you did not: American LegalNet, Inc. www.FormsWorkflow.com Page 6 of 10 12. State concisely every ground on which you claim that you are being held unlawfully. Summarize briefly the facts supporting each ground. If necessary, you may attach pages stating additional grounds and facts supporting same. CAUTION: If you fail to set forth all grounds in this motion, you may be barred from presenting additional grounds at a later date. For your information, the following is a list of the most frequently raised grounds for relief in these proceedings. Each statement preceded by a letter constitutes a separate ground for possible relief. You may raise any grounds which you may have other than those listed. However, you should raise in this petition all available grounds (relating to this conviction) on which you based your allegations that you are being held in custody unlawfully. DO NOT CHECK ANY OF THESE LISTED GROUNDS. If you select one or more of these grounds for relief, you must allege facts. The motion will be returned to you if you merely check (a) through (j) or any of these grounds. (a) Conviction obtained by plea of guilty which was unlawfully induced or not made voluntarily or with understanding of the nature of the charge and the consequences of the plea. (b) Conviction obtained by use of coerced confession. (c) Conviction obtained by use of evidence gained pursuant to an unconstitutional search and seizure. (d) Conviction obtained by use of evidence obtained pursuant to an unlawful arrest. (e) Conviction obtained by a violation of the privilege against self-incrimination. (f) Conviction obtained by the unconstitutional failure of the prosecution to disclose to the defendant evidence favorable to the defendant. (g) Conviction obtained by a violation of the protection against double jeopardy. (h) Conviction obtained by action of a grand or petit jury which was unconstitutionally selected and impaneled. (i) Denial of effective assistance of counsel. (j) Denial of right to appeal. American LegalNet, Inc. www.FormsWorkflow.com Page 7 of 10 A. Ground One: Supporting FACTS (tell your story briefly without citing cases or law): B. Ground Two: Supporting FACTS (tell your story briefly without citing cases or law): C. Ground Three: Supporting FACTS (tell your story briefly without citing cases or law): American LegalNet, Inc. www.FormsWorkflow.com Page 8 of 10 D. Ground Four: Supporting FACTS (tell your story briefly without citing cases or law): 13. If any of the grounds listed in 12A, B, C, and D were not previously presented, state briefly what grounds were not so presented, and give your reasons for not presenting them: 14. Do you have any petition or appeal now pending in any court as to the judgment under attack? Yes No 15. Give the name and address, if known, of each attorney who represented you in the following stages of the judgment attacked herein: (a) At preliminary hearing: American LegalNet, Inc. www.FormsWorkflow.com Page 9 of 10 (b) At arraignment and plea: (c) At trial: (d) At sentencing: (e) On appeal (f) In any post-conviction proceeding: (g) On appeal from any adverse ruling in a post-conviction proceeding: American LegalNet, Inc. www.FormsWorkflow.com Page 10 of 10 16. Were you sentenced on more than one count of an indictment, or on more than one indictment, in the same court and at approximately the same time? No Yes 17. Do you have any future sentence to serve after you complete the sentence imposed by the judgment under attack? Yes No (a) If so, give name and location of court which imposed sentence to be served in the future: (b) And give date and length of sentence to be served in the future: (c) Have you filed, or do you contemplate filing, any petition attacking the judgment which imposed the sentence to be served in the future? Yes No Wherefore, movant prays that the Court grant petitioner relief to which he may be entitled in this proceeding. Signature of Attorney (if any) Firm Name Address City, State & Zip Code Telephone (including area code) I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on (date). American LegalNet, Inc. www.FormsWorkflow.com