Tenn. R. Sup. Ct., app D
The following form petition shall be available without cost to a prisoner in the prisons and other places of detention and shall also be available without cost to any potential petitioner in the office of the clerk of court for any court of record with criminal jurisdiction. The Post-Conviction Procedure Act contemplates the filing of only one (1) petition for post-conviction relief. A motion to reopen should be filed only under the limited circumstances set out in Tenn. Code Ann. § 40-30-117.
READ THESE INSTRUCTIONS CAREFULLY BEFORE PREPARING THE PETITION
(1) This petition must be legibly handwritten or typewritten and must be signed by petitioner 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 completely in the proper space on the form or on additional sheets submitted with the form. This form may be obtained at the place of confinement corrections institution where you are confined or from any clerk of a court of record with criminal jurisdiction.
(2) No citation of authorities need be furnished. If briefs or arguments are submitted, they should be submitted in the form of a separate memorandum and not as part of this form.
(3) A separate petition must be filed for each judgment you seek to challenge. Only the judgments entered in a single trial or guilty plea proceeding may be challenged in a particular petition. If you seek to challenge judgments entered in different trials or guilty plea proceedings, either in the same county or in different counties, you must file separate petitions.
(4) YOU MUST INCLUDE IN THIS PETITION ALL GROUNDS FOR RELIEF. FAILURE TO INCLUDE A GROUND FOR RELIEF IN THIS PETITION WILL RESULT IN YOUR BEING BARRED FROM PRESENTING IT IN A FUTURE PETITION.
(5) YOU MUST INCLUDE ALL FACTS SUPPORTING EACH GROUND FOR RELIEF. YOU MUST BE AS SPECIFIC AS POSSIBLE AS TO THE FACTS.
(6) Complete all applicable items in the petition. When the petition is fully completed, the ORIGINAL must be mailed to the appropriate clerk of court.
(7) You must comply with these instructions in order to have your petition promptly considered.
(8) REMEMBER, A PETITIONER IS ENTITLED TO FILE ONLY ONE PETITION PER CASE.
IN THE ______ COURT OF _________ COUNTY, TENNESSEE
AT ___________
___________ | ) | |
PETITIONER (FULL NAME) | ) | |
) | ||
VS. | ) | CASE NO. _________ |
) | ||
) | (POST-CONVICTION) | |
STATE OF TENNESSEE | ) |
MOTION TO REOPEN POST-CONVICTION PETITION
Mailing Address of Petitioner _____________________
(including zip code) _____________________
_____________________
Place of Confinement _____________
Department of Corrections Number _________
NOTICE: BEFORE COMPLETING THIS FORM, CAREFULLY READ THE ACCOMPANYING INSTRUCTIONS.
1. Name and location (city and county) of court which entered the judgment of conviction or sentence under attack ____________________________________________________________________________________
2. Date of judgment of conviction _____________________
3. Case Number _____________________
4. Length of sentence _____________________
5. Offense convicted of ________________________________________________________________
6. What was your plea? (Check one)
(a) Guilty _____
(b) Not Guilty _____
(c) Not Guilty by reason of mental disease or defect _____
(d) Not guilty and not guilty by reason of mental disease or defect _____
(e) Nolo contendere _____
(f) None _____
If you entered a guilty plea to one count or indictment, and a not guilty plea to another count or indictment, specify:
(a) Guilty plea counts: _____________________
(b) Not guilty plea counts: _____________________
7. Give the following information in regard to the post-conviction proceeding(s) you seek to reopen at this time:
(a) _____________________
(1) Name and location of post-conviction trial court _____________________
(2) Grounds raised __________________________________________________________________
______________________________________________________________
(attach additional sheets if necessary)
(3) Did you receive an evidentiary hearing on your petition, application or motion?
Yes _____ No _____
(4) Result _____________________
(5) Date of result _____________________
(b) Did you appeal to any appellate court the result of the action taken on that petition?
Yes _____ No _____
(c) If you did not appeal when you lost the petition, explain briefly why you did not appeal: _____________________
_____________________ __________________________________________
8. What grounds exist under Tenn. Code Ann. § 40-30-117 to justify reopening the first post-conviction petition? Check all that apply.
_____(a) A state or federal appellate court has issued a final ruling establishing a constitutional right that was not recognized as existing at the time of trial but now is required to be recognized and applied in your case.
(1) What was the name and style of the case establishing the constitutional right? _____________________
(2) On what date was that opinion or ruling filed? _____________________
(3) If more than one (1) year has passed since the appellate court ruled establishing this new constitutional right, state why the one year statute of limitations should not bar you claim. ____________________________________________________________________________________
(4) Attach a separate sheet of paper listing each constitutional right that you claim that was not recognized as existing at the time of your trial but is now required to be recognized and applied in your case. Include all facts of your case which support your claim that this right now entitles you to relief. Specify how you were prejudiced.
_____(b) There exists new scientific evidence that establishes that you are actually innocent of the offense or offenses for which you were convicted.
(1) What is the scientific evidence consist of ? _______________________________________________________________
(2) On what date did the scientific evidence come into existence? _____________________
(3) How and when did you become aware of the existence of this evidence? _______________________________________________________________
(4) How does the evidence establish your actual innocence? _______________________________________________________________
_____ (c) The sentence in this case was enhanced because of a prior conviction has subsequently been held to be invalid.
(1) Name and location of court which entered the judgment of the prior conviction. _____________________ _____________________
(2) Case number of prior case. _____________________
(3) Name and location of court that held the prior conviction invalid. _______________________________________
(4) Date the conviction held invalid. __________________________________________
(5) Describe how the prior conviction was used to enhance the sentence you are now attacking. _____________________ _______________________________________________________________
(6) If more than one (1) year has passed since the date the prior conviction was set aside, state why the one year statute of limitations should not bar your claim. ______________________________________________________________________
9. Do you have any petition or appeal now pending in any court, either state or federal, as to the judgment under attack?
Yes _____ No _____
10. Give the name(s) and address(es), if known, of each attorney who represented you on your petition for post-conviction relief.
(a) In any post-conviction proceeding _______________________________________________________________
(b) On appeal from adverse ruling in a post-conviction proceeding _______________________________________________________________
11. Are you currently represented by counsel?
Yes _____ No _____
If Yes, give name and address, if known, of the attorney representing you. _______________________________________________________________
If No, do you wish to have an attorney appointed? Yes _____ No _____
12. Has any attorney assisted in drafting or given advice regarding drafting this petition for post-conviction relief?
Yes _____ No _____
If Yes, give name and address of attorney(s). __________________________________________________________________
13. In the judgment you are attacking, were you sentenced on more than one count of an indictment, or on more than one indictment, in the same court at the same time?
Yes _____ No _____
14. Do you have any future sentence to serve after you complete the sentence imposed by the judgment under attack?
Yes _____ No _____
(a) If so, give name and location of court which imposed sentence to be served in the future: _____________________
(b) And give date and length of sentence to be served in the future: _____________________
(c) Have you filed, or do you contemplate filing, any petition attacking the judgment which imposed the sentence to be served in the future?
Yes _____ No _____
15. What date is this motion being given to prison authorities for mailing?
Wherefore, petitioner prays that the court grant petitioner's motion to reopen the post-conviction proceedings and grant any relief to which petitioner may be entitled in this proceeding.
PETITIONER'S VERIFICATION UNDER OATH SUBJECT TO PENALTY FOR PERJURY
I swear (or affirm) under penalty of perjury that the foregoing is true and correct. Executed on ___________.
(Date)
_____________________
Signature of Petitioner
SWORN TO AND SUBSCRIBED before me this the ___ day of _______, 20___.
_____________________
Notary Public
My commission expires: _____________________
Tenn. R. Sup. Ct., app D