UNITED STATES COURT of APPEALS for the NINTH CIRCUIT 95 Seventh Street San Francisco, California 94103 Application for Leave to File Second or Successive Petition Under 28 U.S.C. § 2254 or Motion Under 28 U.S.C. § 2255 Docket Number ____________________________________________________ (to be provided by court) Petitioner’s name ___________________________________________________ Prisoner registration number ___________________________________________ Address __________________________________________________________ Instructions - Read Carefully (1) This application, whether handwritten or typewritten, must be legible and signed by the petitioner under penalty of perjury. An original and five (5) copies must be provided to the Clerk of the Ninth Circuit. The application must comply with 9th Circuit Rule 22-3, which is attached to this form. (2) All questions must be answered concisely. Add separate sheets if necessary. (3) The petitioner shall serve a copy of this application and any attachments on respondent and must complete and file a proof of service with this application. (4) The petitioner shall attach to this application copies of the magistrate judge’s report and recommendation and the district court’s opinion in any prior federal habeas proceeding under 28 U.S.C. § 2254 or § 2255 or state why such documents are unavailable to petitioner. You Must Answer the Following Questions: (1) What conviction(s) are you challenging? _________________________________________________________________ _________________________________________________________________ (2) In what court(s) were you convicted of these crime(s)? _________________________________________________________________ _________________________________________________________________ (3) What was the date of each of your conviction(s) and what is the length of each sentence? _________________________________________________________________ _________________________________________________________________ For questions (4) through (9), provide information separately for each of your previous §§ 2254 or 2255 proceedings. Use additional pages if necessary. (4) With respect to each conviction and sentence, have you ever filed a petition or motion for habeas corpus relief in federal court under 28 U.S.C. § 2254 or § 2255? Yes ? No ? (a) In which federal district court did you file a petition or motion? ______________________________________________________________ (b) What was the docket number? ____________________________________

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