ae x0 21 Poe IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA 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 conviction of the sentence. This form is your petition for relief. 2. 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 centered. If you want to challenge a federal judgment that imposed a scntence 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, 3. Your habeas corpus petition must be filed within the 1-year statute of limitations time limit sot forth in 28 U.S.C. § 2244(d)(1). (There are limited circumstances in which the petition may be amended, within the one-year time period, to add additional claims or facts, see Federal Rules of Civil Procedure 15; or amended after the one-year period expires, in order to clarify or amplify claims which were timely presented, see United States v. Thomas, 221 F. 34 430 (3d Cir. 2000). 4. Make sure the form is typed or neatly written. 5. 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. 6. 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 argument, 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 Application to Proceed in District Court Without Prepaying Fees or Costs. Also, you must submit a certificate signed by an officer at the institution where you are contined showing the amount of money that the institution is holding for you,10. 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. As required by 28 U.S.C. § 2254(b)(1), you must have exhausted all claims that you are making in your petition. This means that every claim must have been presented to cach level of the state courts. If you file a petition that contains claims that are not exhausted, the federal court will dismiss your petition, 28 U.S.C, § 2254(b)(2) provides that the federal court may deny your petition on the merits even if you have not exhausted your remedies. As required by 28 U.S.C. § 2244(b)(1), a federal court must dismiss any claim in a second or successive habeas corpus petition that was presented in a prior habeas corpus petition. [As required by 28 U.S.C. § 2244(b)(2). a federal court must dismiss any claim in a second. oor successive habeas corpus petition that was not presented in a prior habeas corpus petition unless you show: (A) the claim relies on a new rule of constitutional law, made retroactive to cases on collateral review by the U.S. Supreme Court, that was previously unavailable; or (B) (i) the factual predicate for the claim could not have been discovered previously through the exercise of due diligence, and (ii) the facts underlying the claim, if proven and viewed in light of the evidence as a whole, would be sufficient to establish by clear and convincing evidence that, but for constitutional error, no reasonable fact finder would have found you guilty of the offense in question. Before such a second or successive petition may be filed in the district court. however. the petitioner must move in the court of appeals for an Order authorizing the district court to consider the petition, Petitioner's motion for such an Order must be determined by a three judge panel of the court of appeals. which must grant or deny the motion within 30 days, The court of appeals may grant the motion only if it determines that the petition makes a prima facie showing that it satisfies either (A) or (B) above. When you have completed this form, send the original, three copies, and these instructions to the Clerk of the United States District Court at this address: Clerk United States District Court for the Eastern District of Pennsylvania 601 Market Street, Room 2609 Philadelphia, PA 19106Pag A041 Poses 13. CAUTION: You must 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. 14. CAPITAL CASES: If you are under a sentence of death, you are entitled to the assistance of counsel and should request the appointment of counsel.PETITION UNDER 28 USS.C. § 2254 FOR WRIT OF HABEAS CORPUS BY A PERSON IN STATE CUSTODY United States Distriet Court District: Eastern District of Pennsylvania Name (under which you were convicted): | Docket or Case No. Gaucey). Cerone) CYA S- 3924 [Pesgmees Ah ee ea ai —i“ “= as ¥ repo orne ate County ot AMCTTTER = he Aroraey General tte fst A PELETION 1G) Name gd tocation of cout emered the udement of convstign you are calle _ of Cuttin Fe _ (b) —Coiminal docket ase umber if you know i 2.) Dateofjudgment of conviction (if yu know ( Dateef mosesing: _ a eat [LoATMNE TT 4. tmeincatawereyousonitdon noe tan one coun orofmme tunoee cine? YG No 5 tdeiyall crn whisk you wer convicted and sentenced ints ewe pe Toten JeLaret§ DMS if8, (a) What yas your plea? (Check one) 1) Not Guilty (3) Nolo contendere (no contest) De) Guilty ed) Insanity plea (b) Lf youentered a guilty plea to one count or charge and a not guilty plea to another count or charge, what did you plead guilty to and what did you plead not guilty 10? (fc) you went wal what kind of trial did you have? (Check one) . Oley Judue only BOF Hane é Did you testify ata pretrial hearing, tral, oa post-rial hearin Yes oO vo Did you appeal rom the dent of conviton? a Yes 2 vo Ifyou did appeal, answer the following (a) Name of court: (b) Docket or ease number tif you know) = fe) Result (a) Date of result (if you know (2) Citation to the case (if you know): (Grounds raised:aeso28 ne (g) Did you seek further review by a higher state court? O Ys at Uys, answer he following (1) Name of cou: a (2) Docket or ease number (if you 204} (3) Result (4) Date of result if you know) (5) Citation to the case i you know: (6) Grounds raised: So TO thy Did you ile petition for certiorar inthe United States Supreme Cour? CJ Yes. Do lees, answer the following (1) Docket o ese number (you know) (2) Result: = (3) Date of elt (if 0 kao: (4) Citation to the cas i you know: 10. Other than the direct appeals listed above, have you previously ied anyother petions,aplieation, or ‘motions concerning this judgment of convition in any stat cour? a Ys wKo 11. If your answer to Question 10 was “Yes.” ny jive the following information: (1) Name of coun: (2) Docket or ease number (if you know): _ (3) Date of filing (if you know: (4) Nature ofthe proceeding: — (5) Grounds raised:(6) Did you: as where evidence was given on your petition, aplication, or motion? Ye O No ey Rente Ue 2 20 Dis Pater TERTURT (8) Date of result (if you know (b) Ifyou fled any second petition, application, or motion, give the same information: (1) Name of court: (2) Docket or case number (if you know) G) Date of filing (if you know: (4) Nature of the proceeding: (5) Grounds raise (6) Did you receive a hearing where evidence was given on your petition, application, or motion? O° Yes a No (7) Result (8) Date of result ifyou Know): ic) {F you filed any thd petition, application. or motion. give the same information: (1) Name of court: (2) Docket or ease number (if you know (3) Date of filing i?you know): (4) Nature ofthe proceeding: (5) Grounds mised: = _(6) Did you receive @ hearing where evidence was given on your petition, application, or motion? Dyes D No (7) Result (8) Date of result (if you know); (2) Did you appeal to the highest state court having jurisdiction over the action taken on your petition, application, or motion: (1) First petition: Yes & No (2) Second petition: a yes & No (3) Thied petition: Yes BNo (e) Ifyou did not appeal the highest state court having jurisdiction, explain why you didnot: 2. Fortis petition, state every ground on which you claim that you ae being held in violation of the Constitution. laws, or treaties of the United States. Attach additional pages if you have more than four srounds. State the facts supporting each around, action by the federal wy ng additional erounds at GROUND ONE: U.S.¢. L 18 0.8.0. C Bence Bier of Lie tet 18 0.5.4. ff 2261-4 (a) Supporting facts (Do not argue or cite law. Just state the specifi facts that support your claim.)(by If you did noyexhaust your ite remedies on Ground One, explain why ls caadwer Mitel Lg crdren Chou? 6 Jew rot ite CohlP Tins (c) Direct Appeal of Ground O1 (1) If you appeated from the judgment of conviction, did you raise this issue? O yes O No (2) Ifyou did not raise this issue in your direct appeal, explain why? (a) Post-Convietion Proceedings: (1) Did you raise this issue through a post-conviction motion or petition for habeas corpus in a D ves ww (2) If your answer 10 Question (@)(1) is “Yes.” state: state trial cour’? ype of motion or petition: Name and location of the court where the motion or petition was fled: _ Docket of case number (if you know): a Date of the court's decision: Res nion of order. if available I (attach a copy of the court's 0 nn eee (3) Did you receive a hearing on your motion or petition? O Yes No (4) Did you appeal trom the denial of your motion or petition? O Yes O No (5) If your answer to Question (d)(4) is “Yes.” did you raise this issue in the eppeal? o Yes O No (6) If your answer to Question (d)(4) is “Yes.” state: Name and location of the court where the appeal was filed ee Ee Docket or case number (if you know Date of the court's decision: ee =Pat s0241 rege Result (attach a copy of the court’s opinion or order, if available Eee oo (7) Ifyour answer to Question (d)(4) oF Question (4X5) is “No,” explain why you did not raise thisigsue; oo ee ee ee ee c) Other Remedies: Describe any other procedures (such as habeas corpus, administrative remedies, tc.) that you have used to exhaust your state remedies on Ground One: {b) Ifyou did not exhaust your state remedies on Ground Two. explain why: (c) Direct Appeal of Ground Two: (1) Ifyou appeated from the judgment of conviction, did you raise this issue? a Yes D No"ae A021 Paget (2) If you did not raise this issue in your direct appeal explain why? a er ({) Post-Convietion Proceedings: (1) Did you raise ths issue through a post-conviction motion or petition for habeas corpus in a state trial court? O Yes a No (2) If your answer to Question (d)I) is “Yes.” sate: Type ofmotion orpetition: "Name and location ofthe court where the motion or petition was filed: Se ee Docket or case number (if you know): _ Date of the court's decision: Result (attach a copy of the court's opinion or order. if available) (3) Did you receive a hearing on your motion or petition? Dl Yes O No (4) Did you appeal ftom the denial of your motion or petition? O ves O No (5) If your answer to Question (4)(4) is "Yes." did you raise this issue in the appeal? O Yes DB No (5) IFyour answer to Question (44) is es." state: Name and location of the court where the appeal was filed Docket or case number (if you know: Date of the coun’s decision: available): Result (attach a copy of the court’s opinion or order So se (7) Ifyour answer to Question (a4) oF Question (d)(3) is “No.” explain why you did not raise this issue! SS a a ooPag 4028) (e) Other Remedies: Describe any ther procedures (such as habeas corpus, administrative remedies, etc.) that you have used to exhaust your state remedies on Ground Two: a ee ee GROUND THREE: oo {a) Supporting fuets (Do not argue or cite law. Just state the specific facts that support your claim.) (b) IF you did not exhaust your state remedies on Ground Three, explain why: a \o) Direet Appeal of Ground Three: (1) Ifyou appealed trom the judgment of conviction, did you raise this issue? a Yes Td No (2) Ifyou did not rise this issue in your direct appeal, explain why? ee ee (4) Post-Convietion Proceedings: 1) Di you raise this issue through a post-convition motion oF petition for habeas corpus in state trial court? OD Yes a No 2) If your answer to Question (6)(1) is “Yes.” state: {ype of motion or petition: __te) [Name and location ofthe court where the motion or petition was fle: a Docket or case number (if you know: ede of the cet icici eee ble): Result (attach copy of the court's opinion or order, if a a (3) Did you receive a hearing on your motion ot petition? et (4) Did you appeal from the denial of your motion or petition? eve oe (5) 1tyour answer to Question (44) is “Yes.” did you ris this issue in the appeal? O Yes a No (6) If your answer to Question (dt 4) is “Yes.” state: Name and location ofthe court where the appeal was filed: ———EESSSSSS Docket or ease number (if'youknowy; Date ofthe court's deeision Result (attach a copy of the court's opinion or order, if available): (7) I your answer to Question (d)(4) oF Question (d)(5) is “No.” explain why you did not raise this issue: ee ‘Other Remedies: Describe any other procedures (suchas habeas corpus. administrative remedies, etc.) that you have used to exhaust your state remedies on Ground Three: ee” GROUND FOUR: (a) Supporting facts (Do not argue of cite law, Just state the specific facts that support your claim.(b) Ifyou did not exhaust your state remedies on Ground Four, explain why: _- (c) Direct Appeal of Ground Four: (1) Ifyou appeated from the judgment of vonviction, di you raise this issue? O Yes O No (2) Ifyou didnot raise this issue in your direct appeal, explain why’? (4) Post-Convietion Proceedins (1) Did you raise this issue through a post-conviction motion or petition for habeas corpus in a state trial court? O Yes No (2) If your answer to Question (d)(1) is “Yes.” state: ‘Type of motion or petition: ‘Name and location of the court where the motion or petition was file: Docket or case number (if you know) Date of the court's deeision: Result (attach a copy of the court's opinion or order. if available) ee ee (3) Did you receive a hearing on your motion or petition? O Yes G No (4) Did you appeal from the denial of your motion or petition? a Yes NoPat s020, (5) Ifyour answer to Question (2)(4) is “Yes.” did you raise this issue inthe appeal? O Yes O No (6) If your answer to Question (d)(4) is “Yes.” state "Name and location of the court where the appeal was filed: Docket or case number (if you know): — Date of the court's decision: Result (attach a copy of the cour’s opinion or order if available ee a (7) Ityour answer to Question (4X4) or Question (dS) is “No.” explain why you did not raise fe ee Other Remedies: Deseribe any other procedures (such as habeas corpus, administrative remedies, tc.) that you have used to exhaust your state remedies on Ground Four 13, Please answer these additional questions about the petition you are fling Have all grounds for relief that you have raised in this petition been presented to the highest state court having jurisdiction? a Yes O No Ie your answer is “No,” state which grounds have not been so presented and give your reason(s) for ‘not presenting them: —$_____——ra ge (b) Is there any ground in this petition that has not been presented in some state or federal court? IF so, which ground or grounds have not been presented, and state your reasons for not presenting them: — ee a 14. Have you previously filed any type of petition, application, or motion in a federal court regarding the conviction that you challenge inthis petition? O ves GD No Ves." state the name and location ofthe cour, the docket or ease number, the type of proceeding, the issues raised, the date of the court's decision, and the result for each petition, application, or motion fled. Attach a copy of any court opinion or order, if available, 15. Do you have any petition or appeal now pending (tiled and not decided yet) insany court enter state or federal forthe judgment you are challenging? «Yes O No f"Yes.” state the name and location of the cour. the docket or ease number, the type of proceeding, and the issues raised: Ss 16, Give the name and address, if you know, of each attomey who represented you inthe following stages of ‘the judgment you are challenging: (a) Atpreliminary hearing: (b)—Atarraignment and plea(Atti (4) Atsemtencing Gun (9 Inany post-conviction proceeding: (g)_Onappeal from any ruling against you in 8 post-conviction proceeding 17. Do yurhave any future sentence to serve after you complete the sentence forthe judgment that you a challenging? O Ye No (a) tfso, give the name and location ofthe court that imposed the other sentenee you will serve inte fumure: (6) Givethe date the other sentence was impose: (e) Give he length ofthe other semtenes a) ave you ile. or do you plan tile any petition tha challenges the judgment or sentence 10 be served in the future? O Ys O %o 1s, TIMELINESS OF PETITION: Ifyour judgment of consieton became inal over one year ago, You mst explain why the one-year statute of limitations as contained in 28 U.S.C. § 224(d) does not bar your petition®oo + The Antiterrorism and Effective Death Penalty Act of 1996 ("AEDPA") as contained in 28 U.S.C. § 2244(4) provides in part that: wo ‘A one-year period of limitation shall apply to an application for a writ of habeas corpus by a person in custody pursuant tothe judgment of « State Court. The limitation period shall run from the latest of ry a) © ry the date on which the judgment became final by the conclusion of direct review or the ‘expiration of the time for seeking such reviews the date on which the impediment to filing an application created by State action in ‘violation of the Constitution or laws ofthe United States is removed, if the applicant was prevented from filing by such state acto the date on which the constitutional right asserted was initially recognized by the Supreme Coury ifthe ight has been newly recognized by the Supreme Court and made retroactively applicable to cases on collateral review: of the date on which the factual predicate ofthe claim or claims presented could have been discovered through the exercise of due diligence. ‘The time during which a properly filed application for State post-conviction or other collateral review with respect to the pertinent judgment or claim is pending shall not be counted toward any period of limitation under this subsection, ‘Theretore, petitioner asks that the Court grant the following relief ‘or any other relief to which petitioner may be entitled, Signature of Atomey (ifany)1 declare (or certify, verity, or state) under penalty of perjury that the foregoing is trys and Petition for Writ of Habeas Corpus was placed inthe pegaaemdameansiety on __//= C hamden T bys Pitre, (mori date. year) ature of Petitioner {the person signing is not the petitioner, state the relationship to petitioner and explain why petitioner isnot signing this petition,UNITED STATES DISTRICT COURT FORTHE EASTERN DISTRICT OF PENNSYLVANIA. Play Civil Action No. ‘Defendant APPLICATION FOR PRISONERS TO PROCEED IN DISTRICT COURT WITHOUT PREPAYING FEES OR COSTS (Short Form) | am a plaintiff or petitioner in this case and declare that lam unable to pay the costs of these proceedings and that Lam entitled to the relief requested. In support of this application, I answer the following questions under penalty of perjury 1. Ifincarcerated. ‘am being held at | am employed there, or have an account in the institution. I have attached to this documenta statement certified by the appropriate institutional officer showing al receipts, expenditures. and balances during the last six ‘months for any institutional account in my name. am also submitting a simular statement from any other institution ‘witere | was incarcerated during the last six months. if not incarcerated. 1 am employed. my employer's name and address are: My gross pay or wages are: S and my take-home pay or wages are: 5 _ ‘pis pas period) Other Income. In the past 12 months, [ have received income from the following sources (check all that apply) (a) Business, profession, or other self-employment. Yes No (b) Rent payments, intrest, or dividends Dyes No (©) Pension, annuity or life insurance payments Dyes ONo (a) Disability, or worker's compensation payments Yes C1No (e) Gifts, or inheritances Dyes No (8 Anyother sources Yes BNoyou answered "Yes" to any question above, describe below or on separate pages each source of money and state the amount that you received and what you expget fo receive inthe futur, oS 2 oe ———— 4. Amount of money that I have in cash or in & checking or savings account: 8, 5. Any automobile, eal estate stock, bond, security, trust, jewelry art work, or other financial instrument or thing of value that Fown, including any item of value held in someone else's name (describe the property and its approximate value 6. Any housing, transportation, utilities, or loan payments, or other regular monthly expenses (describe and provide the amount of the monthly expense): 7. Names (or, if under 18, initials only) of all persons who are dependent on me for support. my relationship with each person. and how much I contribute to their Support: S$ ——_ Any debts or financial obligations (describe she amounts owed and to whom they are payable): Declaration: \ declare undee penalty of perjury thatthe above information is true and understand that 8 false statement may result ina dismissal of my claims. Primed mame 9. Certification of Prisoner’s Institutional Account Balance: An authorized prison official must complete the certification below, and furnish a certified copy of your institutional account statement showing ail deposits, withdrawals. and balances for the prior six-month period. to be filed with this application, | certify that the prisoner named herein has the sum of S ‘on account at correctional institution, where he is presently confined. | further certity that during the prior six-month period, the prisoner's average monthly account balance was ind thatthe average amount deposited monthly in the account during the prior six-month riod was of tar Prison Ocal Bae