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OAO 243

(Rev. 2/95)

MOTION UNDER 28 USC § 2255 TO VACATE, SET ASIDE, OR CORRECT SENTENCE BY A PERSON IN FEDERAL CUSTODY (If movant has a sentence to be served in the future under a federal judgment which h e or she w ishes to attack, the m ovant sh ould file a m otion in the federal co urt which entered th e judgm ent.) MOTION TO VACATE, SET ASIDE, OR CORRECT SENTENCE BY A PERSON IN FEDERAL CUSTODY Explan ation an d Instructio ns­Rea d Carefu lly

(1) This motion must be legibly handwritten o r typewritten, and sign ed by the m ovant und er penalty of perju ry. 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 need 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. (4) If you do not have the necessary funds for transcrip ts, counsel, appeal, and other costs connected with a motion of this type, you may request permission to proceed in forma pau peris, in which event you must execute form AO 240 or any other form required by the court, setting forth information establishing your inability to pay the costs. If you wish to proceed in forma paupe ris, you must have an authorized officer at the penal institution complete the certificate as to the amount of money and securities on deposit to y our cred it in any acc ount in th e institution. (5) Only ju dgme nts 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 judgm ent. (6) Your attention is dir ected to the fact that y ou mu st include a ll ground s for relief an d 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 com pleted, the original and at least two copies m ust be mailed to the Clerk of the Un ited States District Cou rt whose address is

(8) Motions which do not conform to these instructions will be returned with a notation as to the deficiency.

AO 243

(Rev. 2/95)

United States District Court
Name of Movant Place of Confinement

MOTION UNDER 28 USC § 2255 TO VACATE, SET ASIDE, OR CORRECT SENTENCE BY A PERSON IN FEDERAL CUSTODY District Prisoner No. Case No.

UNITED STATES OF AMERICA

V.
(name under which convicted)

MOTION
1. Name and location of court which entered the judgment of conviction under attack

2. 3. 4.

Date of judgment of conviction Length of sentence Nature of offen se involved (all cou nts)

5.

What was your plea? (Check one) (a) Not g uilty G (b) Guilty (c) Nolo contendere

G G

If you entered a guilty plea to one co unt or indictme nt, and a not gu ilty plea to another cou nt or indictmen t, give details:

6.

If you pleaded not guilty, what kind of trial did you have? (Check one) (a) Jury G (b) Judg e only

G

7.

Did yo u testify at the tria l? Yes No G G Did you appeal from the judgment of conviction? No G Yes G

8.

(2)

AO 243

(Rev. 2/95)

9.

If you did appeal, answer the following: (a) Name of court (b) Resu lt (c) Date o f result

10.

Other than a direct appeal from the judgment of conviction and sentence, have you previously filed any petitions, applications, or mo tions with re spect to this ju dgme nt in any fe deral cou rt? No G Yes G If your answer to 10 was "yes," give the following information: (a) (1) Name of court (2) Nature of proceeding

11.

(3) Grounds raised

(4) Did you receive an evidentiary hearing on your petition, application or motion? Yes No G G (5) Resu lt (6) Date o f result (b) As to any second petition, application or motion give the same information: (1) Nam e of cou rt (2) Name of proceeding

(3) Grounds raised

(3)

AO 243

(Rev. 2/95)

(4) Did you receive an evidentiary hearing on your petition, application or motion? Yes No G G (5) Resu lt (6) Date o f result (c) Did you appeal, to an appellate federal court having jurisdiction, the result of action taken on any petition, application or motion? No G (1) First petition, etc. Yes G (2) Second petition, etc. Yes

G

No

G

(d) If you d id not app eal from the adve rse action o n any p etition, app lication or m otion, exp lain briefly w hy you did not:

12.

State concisely every ground on which you claim that you are being held in violation of the constitution, laws or treaties of the United States. Summarize briefly the facts supporting each ground. If necessary, you may attach pages stating additional grounds and facts supporting same. C A U T I O N: If you fail to set forth all gro unds in th is motion, you may be barred from presenting additional grounds at a later date. For your inform ation, the following is a list of the most frequently raised grounds for relief in these proceedings. Each statement preceded by a letter co nstitutes a sep arate grou nd for p ossible relief. You may raise any grounds which you have other than those listed. How ever, yo u should raise in this motion 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 mu st allege facts. The mo tion will be returned to you if you m erely check (a) thro ugh (j) or any o ne of these grou nds. (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.

(4)

AO 243

(Rev. 2/95)

(c) (d) (e) (f) (g) (h) (i) (j)

Conviction obtained by use of evidence gained pursuant to an unconstitutional search and seizure. Conv iction obta ined by use of ev idence o btained p ursuant to an unlaw ful arrest. Conviction obtained by a violation of the privilege against self-incrimination. Conviction obtained by the unconstitutional failure of the prosecution to disclose to the defendant evidence favorab le to the defe ndant. Conviction obtained by a violation of the protection against double jeopardy. Conviction obtained by action of a grand or petit jury which was unconstitutionally selected and impaneled. Denial o f effective a ssistance of c ounsel. Denial o f right of ap peal.

A. Ground one:

Supporting FACTS (state briefly without citing cases or law):

B.

Ground two:

Supporting FACTS (state briefly without citing cases or law):

C.

Ground three:

Supporting FACTS (state briefly without citing cases or law):

(5)

AO 243

(Rev. 2/95)

D.

Groun d four:

Supporting FACTS (state briefly without citing cases or law):

13.

If any of the gro unds listed in 12A , B, C, and D w ere not previou sly presented, state briefly w hat ground s 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? No G Yes G 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

15.

(b) At arraignment and plea

(c) At trial

(d) At sentencing

(6)

AO 243

(Rev. 2/95)

(e) On app eal

(f) In any post-conviction proceeding

(g) On appeal from any adverse ruling in a post-conviction proceeding

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? Yes No G G Do you have any future sentence to serve after you complete the sentence imposed by the judgment under attack? Yes No G G (a) If so, give n ame an d location of court w hich im posed se ntence to be served in the futur e:

17.

(b) Give da te and len gth of the above se ntence:

(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 G No G Wherefore, movant prays that the Court grant him all relief to which he may be entitled in this proceeding.

Signature of Attorney (if any)

I declare under penalty of perjury that the foregoing is true and correct. Executed on

Date

Signature of Movant

(7)