United States Court of Appeals
For the First Circuit
____________________ CERTIFICATE OF DEATH PENALTY CASE CASE INFORMATION CASE NAME DISTRICT COURT CASE NO. TYPE OF PROCEEDING Criminal proceeding. Notice of intent to seek death penalty filed on 2254 petition filed on 2255 motion filed on Other (please specify: EXECUTION DATE (If applicable) ) proceeding initiated on LOCATION DISTRICT OF PLEASE SELECT
PARTY INFORMATION NAME OF DEFENDANT/PETITIONER INSTITUTION OF INCARCERATION REG. NO.
COUNSEL INFORMATION COUNSEL FOR DEFENDANT/PETITIONER Name Address Name Address
Telephone Cell Phone Fax Email
Telephone Cell Phone Fax Email
COUNSEL FOR GOVERNMENT Name Address Name Address
Telephone Cell Phone Fax Email
Telephone Cell Phone Fax Email
Filer's Name Date
Filer's Signature
Note: The court may periodically request status reports. The parties are under a continuing affirmative obligation to immediately notify the court of any changes or additions to the information contained on this form.
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