UNITED STATES COURT OF APPEALS

FOURTH CIRCUIT

APPLICATION FOR LEAVE TO FILE A SECOND OR

SUCCESSIVE MOTION TO VACATE, SET ASIDE

OR CORRECT SENTENCE

28 U.S.C. § 2255

BY A PRISONER IN FEDERAL CUSTODY

Name

Place of Confinement

INSTRUCTIONS—READ CAREFULLY

Prisoner Number

This application must be legibly

handwritten or typewritten and signed by

the applicant 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.

The Judicial Conference of the United States has adopted the 8½ x 11 inch paper size for use throughout the federal judiciary and directed the elimination of the use of legal size paper. All pleadings must be on 8½ x 11 inch paper, otherwise we cannot accept them.

All applicants seeking leave to file a second or successive petition are required to use this form, except in capital cases. In capital cases only, the use of this form is optional.

Additional pages are not permitted except with respect to additional grounds for relief and facts which you rely upon to support those grounds. DO NOT SUBMIT SEPARATE

PETITIONS, MOTIONS, BRIEFS, ARGUMENTS, ETC., EXCEPT IN CAPITAL CASES

In accordance with the “Antiterrorism and Effective Death Penalty Act of 1996,” as codified at 28 U.S.C. § 2255, effective April 24, 1996, before leave to file a second or successive motion can be granted by the United States Court of Appeals, it is the applicant’s burden to make a prima facie showing that he satisfies either of two conditions stated below.

A second or successive motion must be certified as provided in

[28 U.S.C.] Section 2255 by a panel of the appropriate court of

appeals to contain-

(1) newly discovered evidence that, if proven and

viewed in light of the evidence as a whole, would be

sufficient to establish by clear and convincing

evidence that no reasonable fact finder would have

found the movant guilty of the offense; or

(2) a new rule of constitutional law, made

retroactive to cases on collateral review by the

Supreme Court, that was previously unavailable.

When this application is fully completed, the original and three copies must be mailed to:

Clerk of Court

United States Court of Appeals for the Fourth Circuit

1100 E. Main Street, 5^th Floor

Tenth and Main Streets

Richmond, VA 23219

APPLICATION

1. (a) State and division of the United States District Court which entered the judgment of conviction under attack___________________________

____________________________________________________________

(b) Case number_____________________________________________

2. Date of judgment of conviction____________________________________

3. Length of sentence _____________Sentencing Judge__________________

4. Nature of offense for which you were convicted:______________________

_____________________________________________________________

5. Related to this conviction and sentence, have you ever filed a motion to vacate pursuant to 28 U.S.C. § 2255 in any federal court?

Yes  No  If “yes”, how many times? ________ (if more than

One, complete 6 and 7 below as necessary)

(a) Name of court ______________________________________________

(b) Date filed___________________ (c) Case Number_________________

(d) Grounds raised (list all grounds; use extra pages if necessary)_________

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

(e) Result

Denied  Granted  Other (explain below)

________________________________________________________

What reasons did the Court give for its ruling?

________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

(f) Date of result_______________________________________________

6. As to any second federal motion, give the same information:

(a) Name of court ______________________________________________

(b) Date filed___________________ (c) Case Number_________________

(d) Grounds raised (list all grounds; use extra pages if necessary)_________

(e) Result

Denied  Granted  Other (explain below)

________________________________________________________

What reasons did the Court give for its ruling?

________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

(f) Date of result _______________________________________________

7. As to any third federal motion, give the same information:

(a) Name of court ____________________________________________

(b) Date filed___________________ (c) Case Number_________________

(d) Grounds raised (list all grounds; use extra pages if necessary)_________

(e) Result

Denied  Granted  Other (explain below)

________________________________________________________

What reasons did the Court give for its ruling?

________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

(f) Date of result_______________________________________________

8. State concisely every ground on which you now claim that you are being held unlawfully. Summarize briefly the facts supporting each ground.

A. Ground one: _____________________________________________

________________________________________________________

Supporting FACTS (tell your story briefly without citing case or law):

Does this claim rely on a “new rule of constitutional law?”

Yes  No  If “yes,” state the new rule of law (give case name

and citation): _____________________________________________

________________________________________________________

Does this claim rely on “newly discovered evidence, and why was it not previously available to you? ______________________________

________________________________________________________

B. Ground two: _____________________________________________

________________________________________________________

Supporting FACTS (tell your story briefly without citing case or law):

Does this claim rely on a “new rule of constitutional law?”

Yes  No  If “yes,” state the new rule of law (give case name

and citation): _____________________________________________

________________________________________________________

Does this claim rely on “newly discovered evidence, and why was it not previously available to you? ______________________________

________________________________________________________

[Additional grounds may be asserted on additional pages if necessary]

9. Do you have any motion or appeal now pending in any court as to the judgment now under attack? Yes  No 

If “yes,” name of court __________________ Case Number_____________

Wherefore, applicant prays that the United States Court of Appeals for the

Fourth Circuit grant an Order Authorizing the District Court to Consider

Applicant’s Second or Successive Motion to Vacate under 28 U.S.C. § 2255.

______________________________

Applicant’s Signature

I declare under Penalty of Perjury that my answers to all the questions in this

Application are true and correct.

Executed on __________________________

[date]

_______________________________

Applicant’s Signature

PROOF OF SERVICE

Applicant must send a copy of this application and all attachments to the United States Attorney’s office in the district in which you were convicted.

I certify that on__________________, I mailed a copy of this Application* and

all attachments to ___________________________________________________

at the following address:

____________________________________________________________________________________________________________________________________

_________________________________

Applicant’s Signature

________________________

* Pursuant to Fed.R.App.P.25(a), “Papers filed by an inmate confined in an institution are timely filed if deposited in the institution’s internal mail system on or before the last day of filing. Timely filing of papers by inmate confined in an institution may be shown by a notarized statement or declaration (in compliance with 28 U.S.C. § 1746) setting forth the date of deposit and stating that first-class postage has been prepaid.”

UNITED STATES COURT OF APPEALS

FOURTH CIRCUIT

APPLICATION FOR LEAVE TO FILE A SECOND OR

SUCCESSIVE MOTION TO VACATE, SET ASIDE

OR CORRECT SENTENCE

28 U.S.C. § 2255

BY A PRISONER IN FEDERAL CUSTODY

Name

Place of Confinement

INSTRUCTIONS—READ CAREFULLY

Prisoner Number

This application must be legibly

handwritten or typewritten and signed by

the applicant 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.

All applicants seeking leave to file a second or successive petition are required to use this form, except in capital cases. In capital cases only, the use of this form is optional.

Additional pages are not permitted except with respect to additional grounds for relief and facts which you rely upon to support those grounds. DO NOT SUBMIT SEPARATE

PETITIONS, MOTIONS, BRIEFS, ARGUMENTS, ETC., EXCEPT IN CAPITAL CASES

A second or successive motion must be certified as provided in

[28 U.S.C.] Section 2255 by a panel of the appropriate court of

appeals to contain-

(3) newly discovered evidence that, if proven and

viewed in light of the evidence as a whole, would be

sufficient to establish by clear and convincing

evidence that no reasonable fact finder would have

found the movant guilty of the offense; or

(4) a new rule of constitutional law, made

retroactive to cases on collateral review by the

Supreme Court, that was previously unavailable.

When this application is fully completed, the original and three copies must be mailed to:

Clerk of Court

United States Court of Appeals for the Fourth Circuit

1100 E. Main Street, 5^th Floor

Tenth and Main Streets

Richmond, VA 23219

APPLICATION

1. (a) State and division of the United States District Court which entered the judgment of conviction under attack___________________________

____________________________________________________________

2. Date of judgment of conviction____________________________________

3. Length of sentence _____________Sentencing Judge__________________

4. Nature of offense for which you were convicted:______________________

_____________________________________________________________

5. Related to this conviction and sentence, have you ever filed a motion to vacate pursuant to 28 U.S.C. § 2255 in any federal court?

Yes  No  If “yes”, how many times? ________ (if more than

One, complete 6 and 7 below as necessary)

(d) Date filed___________________ (c) Case Number_________________

(d) Grounds raised (list all grounds; use extra pages if necessary)_________

(g) Result

Denied  Granted  Other (explain below)

________________________________________________________

What reasons did the Court give for its ruling?

________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

(h) Date of result_______________________________________________

7. As to any second federal motion, give the same information:

(a) Name of court ______________________________________________

(b) Date filed___________________ (c) Case Number_________________

(d) Grounds raised (list all grounds; use extra pages if necessary)_________

(e) Result

Denied  Granted  Other (explain below)

________________________________________________________

What reasons did the Court give for its ruling?

________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

(g) Date of result _______________________________________________

7. As to any third federal motion, give the same information:

(e) Name of court ____________________________________________

(f) Date filed___________________ (c) Case Number_________________

(d) Grounds raised (list all grounds; use extra pages if necessary)_________

(i) Result

Denied  Granted  Other (explain below)

________________________________________________________

What reasons did the Court give for its ruling?

________________________________________________________

________________________________________________________________________________________________________________________________________________________________________

(j) Date of result_______________________________________________

8. State concisely every ground on which you now claim that you are being held unlawfully. Summarize briefly the facts supporting each ground.

C. Ground one: _____________________________________________

________________________________________________________

Supporting FACTS (tell your story briefly without citing case or law):

Does this claim rely on a “new rule of constitutional law?”

Yes  No  If “yes,” state the new rule of law (give case name

and citation): _____________________________________________

________________________________________________________

Does this claim rely on “newly discovered evidence, and why was it not previously available to you? ______________________________

________________________________________________________

D. Ground two: _____________________________________________

________________________________________________________

Supporting FACTS (tell your story briefly without citing case or law):

Does this claim rely on a “new rule of constitutional law?”

Yes  No  If “yes,” state the new rule of law (give case name

and citation): _____________________________________________

________________________________________________________

Does this claim rely on “newly discovered evidence, and why was it not previously available to you? ______________________________

________________________________________________________

[Additional grounds may be asserted on additional pages if necessary]

9. Do you have any motion or appeal now pending in any court as to the judgment now under attack? Yes  No 

If “yes,” name of court __________________ Case Number_____________

Wherefore, applicant prays that the United States Court of Appeals for the

Fourth Circuit grant an Order Authorizing the District Court to Consider

Applicant’s Second or Successive Motion to Vacate under 28 U.S.C. § 2255.

______________________________

Applicant’s Signature

I declare under Penalty of Perjury that my answers to all the questions in this

Application are true and correct.

Executed on __________________________

[date]

_______________________________

Applicant’s Signature

PROOF OF SERVICE

Applicant must send a copy of this application and all attachments to the United States Attorney’s office in the district in which you were convicted.

I certify that on__________________, I mailed a copy of this Application* and

all attachments to ___________________________________________________

at the following address:

____________________________________________________________________________________________________________________________________

_________________________________

Applicant’s Signature

________________________