Other: Any other requests must be accompanied by a statement explaining why the item(s) should be taxed pursuant to Circuit Rule 39-1. Additional items without such supporting statements will not be considered. Attorneys fees cannot be requested on this form. * If more than 7 excerpts or 20 briefs are requested, a statement explaining the excess number must be submitted. ** Costs per page may not exceed .10 or actual cost, whichever is less. Circuit Rule 39-1. I, _______________, swear under penalty of perjury that the services for which costs are taxed were actually and necessarily performed, and that the requested costs were actually expended as listed. Signature: _______________________________________ Date: ___________________________________________ Name of Counsel (printed or typed): ___________________________ Attorney for: ____________________________________________ Date: ________________ Costs are taxed in the amount of $ __________________________ Clerk of Court By: _______________________ , Deputy Clerk Form 11. Certificate of Compliance Pursuant to Circuit Rules 35-4 and 40-1 Form Must be Signed by Attorney or Unrepresented Litigant and Attached to the Back of Each Copy of the Petition or Answer (signature block below) I certify that pursuant to Circuit Rule 35-4 or 40-1, the attached petition for panel rehearing/petition for rehearing en banc/answer is: (check applicable option) ____ Proportionately spaced, has a typeface of 14 points or more and contains __________ words (petitions and answers must not exceed 4,200 words). or ____ Monospaced, has 10.5 or fewer characters per inch and contains _______ words or ________ lines of text (petitions and answers must not exceed 4,200 words or 390 lines of text). or ____ In compliance with Fed. R. App. 32(c) and does not exceed 15 pages. ________________________ Signature of Attorney or Unrepresented Litigant (New Form 7/1/2000) Form 12. Application for Leave to File Second or Successive Petition Under 28 U.S.C. § 2254 or Motion Under 28 U.S.C. § 2255 (New 7/1/02)

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