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Pro Se Petition For Writ Of Habeas Corpus AO 241 - Indiana
| Pro Se Petition For Writ Of Habeas Corpus Form. This is a Indiana form and can be used in Northern District District Court Federal . |
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OAO 241(Rev. 10/07) (INND Rev. 3/10) Northern District of Indiana Pro Se Petition for Relief From a Conviction or Sentence By a Person in State Custody (Petition Under 28 U.S.C. § 2254 for a Writ of Habeas Corpus) Instructions 1. To use this form, you must be a person who is currently serving a sentence under a judgment against you in a State court. You are asking for relief from the conviction or the sentence. This form is your petition for relief. You may also use this form to challenge a State judgment that imposed a sentence to be served in the future, but you must fill in the name of the State where the judgment was entered. If you want to challenge a federal judgment that imposed a sentence to be served in the future, you should file a motion under 28 U.S.C. § 2255 in the federal court that entered the judgment. M ake sure the form is typed or neatly written. You must tell the truth and sign the form. If you make a false statement of a material fact, you may be prosecuted for perjury. Answer all the questions. You do not need to cite law. You may submit additional pages if necessary. If you do not fill out the form properly, you will be asked to submit additional or correct information. If you want to submit a brief or arguments, you must submit them in a separate memorandum. You must pay a fee of $5. If the fee is paid, your petition will be filed. If you cannot pay the fee, you may ask to proceed in forma pauperis (as a poor person). To do that, you must fill out an in forma pauperis petition. Also, you must submit a certificate signed by an officer at the institution where you are confined showing the amount of money that the institution is holding for you and the transactions for the past six months. If your account exceeds $15.00 or if you receive $15.00 or more a month, you must pay the filing fee. In this petition, you may challenge the judgment entered by only one court. If you want to challenge a judgment entered by a different court (either in the same State or in different States), you must file a separate petition. W hen you have completed the form, send the original to the appropriate Clerk's office: District Court Clerk's Office 1300 S. Harrison St. Fort W ayne, IN 46802 District Court Clerk's Office 204 S. M ain St Room 102 South Bend, IN 46601 District Court Clerk's Office 5400 Federal Plaza Hammond, IN 46320 District Court Clerk's Office 230 North Fourth Street P.O. Box 1498 Lafayette, IN 47901 2. 3. 4. 5. 6. 7. 8. 9. CAUTION: You m ust include in this petition all the grounds for relief from the conviction or sentence that you challenge. And you must state the facts that support each ground. If you fail to set forth all the grounds in this petition, you may be barred from presenting additional grounds at a later date. CAPITAL CA SES: If you are under a sentence of death, you are entitled to the assistance of counsel and should request the appointment of counsel. 10. American LegalNet, Inc. www.FormsWorkFlow.com OAO 241(Rev. 10/07) (INND Rev. 3/10) Page 1 NORTHERN DISTRICT OF INDIANA PRO SE PETITION UNDER 28 U.S.C. § 2254 FOR WRIT OF HABEAS CORPUS BY A PERSON IN STATE CUSTODY Name (under which you were convicted): Cause No. (assigned by clerk after filing) Prisoner Number: Place of Confinement : CONVICTION AND SENTENCE 1. (a) Name and location of court that entered the judgment of conviction you are challenging: ___________________ ___________________________________________________________________________________________________ (b) Criminal case number: _____________________________________________________________________________ (c) Date of sentencing: _____/_____/__________ 2. Did you plead guilty? Yes No (d) Length of sentence: ___________________________________ 3. Did you have a jury trial? Yes No 4. List all crimes of which you were convicted in this case: ___________________________________________________ ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ DIRECT APPEAL (do not include post-conviction relief petitions or other collateral attacks in this section) 5. Did you take a direct appeal to the Indiana Court of Appeals? Yes (a) Case number: _____________________________________________ No (b) Date of result:_____/_____/__________ (c) Result: ___________________________________________________________________________________________ 6. Did you directly appeal (or petition to transfer) to the Indiana Supreme Court? Yes (a) Case number: _____________________________________________ No (b) Date of result:_____/_____/__________ (c) Result: ___________________________________________________________________________________________ 7. Did you file a petition for certiorari in the United States Supreme Court? Yes (a) Case number: _____________________________________________ No (b) Date of result:_____/_____/__________ (c) Result: ___________________________________________________________________________________________ FIRST POST-CONVICTION RELIEF PETITION 8. Did you file a post-conviction relief petition in a State circuit or superior court? Yes No (a) Name and location of the court: _____________________________________________________________________ ____________________________________________________________ (b) Date of filing: _____/_____/___________ (c) Case number: _____________________________________________ (d) Date of result: _____/_____/__________ (e) Result: ___________________________________________________________________________________________ 9. Did you appeal to the Indiana Court of Appeals? Yes No (b) Date of result:_____/_____/__________ (a) Case number: _____________________________________________ (c) Result: ___________________________________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com OAO 241(Rev. 10/07) (INND Rev. 3/10) Page 2 10. Did you appeal (or petition to transfer) to the Indiana Supreme Court? Yes (a) Case number: _____________________________________________ No (b) Date of result:_____/_____/__________ (c) Result: ___________________________________________________________________________________________ 11. Did you file a petition for certiorari in the United States Supreme Court? Yes (a) Case number: _____________________________________________ No (b) Date of result:_____/_____/__________ (c) Result:
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