CHAPTER 359

An Act to amend the Code of Virginia by adding a section numbered
8-596.1, relating to the form and contents of certain petitions for

writs of habeas corpus.
: (S 45]
Approved April 2, 1968

Be it enacted by the General Assembly of Virginia:

1. That the Code of Virginia be amended by adding a section numbered
8-596.1, as follows:

§ 8-596.1. (a) Every petition filed by a prisoner seeking a writ of
habeas corpus must be filed on the form set forth in subsection (b)
hereof. The failure to use such form and to comply substantially with
such form shall entitle the court to which such petition is directed to
return such petition to the prisoner pending the use of and substantial
compliance with such form. The petitioner shall be responsible for all
statements contained in the petition and any false statement contained
therein, if the same be knowingly or wilfully made, shall be a ground for
prosecution and conviction of perjury as provided for in § 18.1-273.

Every petition filed by a prisoner seeking a writ of habeas corpus
shall be filed on a form to be approved and provided by the Office of the
Attorney General, the contents of which shall be substantially as follows:
SOCHSSSHSSSSHSHSHEHSSHHHSHSHSHSHSHHECHHHSHHEHESHESEOOHESHHHHCHOBHELCEROSEE

Full name and prison number
(if any) of Petitioner

-VS- (To be supplied by the
Clerk of the Court)

SHOSSHSHSSHSHSSHSSHSHSHSSHTHSSSHSHSHHOHSHSHSFEHHOHHEHHRAELHEEHHHOKSESOHSSHEHHAGEREEE

Name and Title of Respondent

PETITION FOR WRIT OF HABEAS CORPUS

Instructions—Read Carefully

In order for this petition to receive consideration by the Court, it
must be legibly handwritten or typewritten, signed by the petitioner and
verified (notarized). It must set forth in concise form the answers to
each applicable question. If necessary, petitioner may finish his answer
to a particular question on an additional page. Petitioner must make it
clear to which question any such continued answer refers. The petitioner
may also submit exhibits.

Since every petition for habeas corpus must be sworn to under oath,
any false statement of a material fact therein may serve as the basis
of prosecution and conviction for perjury under § 18.1-273. Petitioners
should, therefore, exercise care to assure that all answers are true and
correct.

When the petition is completed, the original and two copies (total of
three) should be mailed to the Clerk of the Court. The petitioner shall

keep one copy.
NOTICE

The granting of a writ of habeas corpus does not entitle the petitioner
to dismissal of the charges for conviction of which he is being detained,
but may gain him no more than a new trial.

Place of Cetention : ...........ccccccccsccccscccsssssccccscssssscssssccccssscsscssscrsscessccsosseccsssscccoscenes
A. Criminal Trial
1. Name and location of court which imposed the sentence from which
you seek relief :

SSHOSSHSHSHSHSHSSHHEHHSSSHSSHSSHHOSHSHSESHEHSHSSSHSSHSHSHSHSHSHSSHHSSHSHSHSHHHOHSHHSSSSESHEHSHSHSHHSHHHHSHHOHSHOHSHSSSEHHHSFADSEHHESCHOSHOSSEHEORESOSS

POSSSHEHSSHSSSSHEHHSHSSHSSHSSHSSHSHSHSHSSHSHSHSSSEHSHSHSSHSSSHSSHSHSSHSHSSHHSHSSHSSHSHSHSSHSHSHSHSHSHSSHSHSSAESHSSSHSHSHSHSHSEHSHSOHHSSSSOEHHHSHTECEEOHHSEETEE

2. The offense or offenses for which sentence was imposed
(include indictment number or numbers if known):

SSHFHHSSHSHSHHHSHSSHHSHHOHSHHSHHSSHHSHOSEHSSHHOSHOHSHSHHSHEHOHHSSSHHOHSHHHHSSTSHSSHHSHHEHHSSHSHHEHSHHSSHCHSHSHHSHHHOHSHSHEHHSHHHSOEHHHOHHOHEEE

SSOHHSSSHSSH HS HSHOHHSSSESHHSSHHSHHSSHSHSEHSSSSHOHETSHOSSSSOHSHOHSHSHSHSSHSSHSHHSHHHSSHHOHSOHSSHSSHHOHSHSHHHSHHOSHHHSHSHHHHHOSESEHECHESEFCEOHEOEEe

Cc.
4. Check which plea you made and whether trial was by jury:

Trial by Jury: ........ ; Trial by judge without jury: acevscees
5. The name and address of each attorney, if any, who represented
you at your criminal trial:

OO OSG OOOO EHHOFOOHHEEHHESSOHEHHOHHHHHHHOHHOEHEHHHOHHOEEEEHEHOEOHEEHEHOEORHOOHEOHEOOHTEOEOOHOHHHO8OH8SEHOOESESEEOORESE

OO OHHSEHSOHSSESHSSHHOHEHHHEHHHHHHESHSHSHSHOSEHHLHHTSHHHHHOHEEHHHFOEOOH8HHEOEHOHHOHHOHHHOHHOEHOCHHHHOCHOHOOHEEEEEHOEOOED
Did you appeal the CONVICtION? ...........sssccssscscsseceeeees
If you answered “yes” to 6, state:
the result and the date in your appeal or petition for certiorari:

List the name and address of each attorney, if any, who represented
you on your appeal:

SPOHSSSSSHHSHSSHSSSHHSSEHSHSESSSHSEHEHSHEHEHEESHHSOHHASHEHEEHSSAEEHHESEHHHHSHSEHRHSHEHOHSHEHEHESHHHHSHHFHEF SHEESH SO HREHKTHHCHEHEHHHESSHESCET ESF OH AESEOE

SOSHOHSHSHOHSHEHHSESHHSHSHHSHSSHSSHHOHHESHHKSHHROHSAESHSSHSHOHSSHHRAHEHSAREHHESHSHSHFHSHSHSHHHHHSHEESHSEHRHHESCHAHHHSSHHSEHHEHHHSHESHHSCHETEHE HEHEHE SEBEEHE

B. Habeas Corpus

Before this petition did you file with respect to this conviction any
other petition for habeas corpus in either a State or federal court? ....
If you answered “yes” to 9, list with respect to each petition:
then name and location of the court in which each was filed:

SOOCSHOHHSOCHSHHSHHSHOHHHSEHSHSEHH SOTO HSHHOOHHOSHHOHSHHSSHHSCHOHHSHHS OHHH HOHHHHEHOOEHESEHOSHEHOHOCHOOHSSESEHEHHOHESHHOEHOHOE

SHOSSHHSOCHSHOHSSHSHHHOHSSHHSHHOSSHSHSSSHHSHSHHSHSHHHHSHSHTHHSSSHHOHSHHSHSSSHOHSHSOHOHEHSSHESEHHOHHSSHSHSHHSEHSOSHCHHHSOHOHHHHOSSHOEHEOE

the name and address of each attorney, if any, who represented
you on your habeas corpus:

SOSOHSHHHSSHSSHSHHSSHOHHHHHOHSSOHSCHSOHHHTHHOHHHHTHSHEHHSHOHSHESHOHHHHSHHHHSHHHOHHHHOHHHTHSSHHS OSHS HHSHOCHOHHHHSSHHHHOSSEEOE

Did you appeal from the disposition of your petition for habeas
COFPUS? ......0.

If you answered “yes” to 11, state:

the result and the date of each petition:

SOHSHHSHHSSSSOSSSHSSSSSHSSSSHHHSHSHSHHSHSHSSHSSHSHSSHSHSSSHHSSHHSHSHSHSHASSSHSSHSHSHSHSHSSHHSHSSHSHHSSHSSSHSHSHSHHSEHESSCHHSSSSHOHSHSSSHSSHETCOHHAOCER

the name and address of each attorney, if any, who represented
you on appeal of your habeas corpus:

C. Other Petitions, Motions

or Applications
List all other petitions, motions or applications filed with any court
following a final order of conviction and not set out in A or B.
Include the nature of the motion, the name and location of the
court, the result, the date, and citations to opinions or orders. Give
the name and address of each attorney, if any, who represented
you.

D. Present Petition

State the grounds which make your detention unlawful, including
the facts on which you intend to rely:
List each ground set forth in 14, which has be
any other proceeding:

SOSSHHESHHHSEHHASEHHE HEHE SHEESH HEHSHSOHSEHHHCHCHSOSHESHOHSCEHSHOESHSESHHCOHSHEEEHOESEOEAHEHEOSE

COCOEEEOHESEHHHHHHHHSHHEOHOSOSSOSODHHHESHESESOHHEHHEH HSE HOH SHEHOSHEEHHEHHSH LETTE HET EEOS

if any ground set forth in 14 has not been prese
list each ground and the reason why it was not:

SCHHHSSSHSHOHSHHSOHSSSHSSEHSHHHHHSCEHETEEHSSE*

SHHESCHSHHHEHSHSHHSHSHSHENHSHASHHSHHSHAEHHSHHOCET

TE OF VIRGINIA
L /COUNTY OF wunciicecccccccccccccccssscssscsceceeees
The above named petitioner being first duly sworn, say:
1. Hesigned the foregoing petition;
2. The facts stated in the petition are true to
information and belief.

SFT SFFCHFOHHHHOHEHHHHHHHOHOHHRESEEHEEESE

Signature of
cribed and sworn to before me
Leceeesesee ay OF ..........ccce0ey LO. ..000000
eeees Notary Bublie 777777
OMMISSION EXPIFES .......cccccccccccssssssecssssccscssenss

The petition will not be filed without payment of co
yetitioner is entitled to proceed in forma pauperis a!

ttached.
FORMA PAUPERIS AFFIDAVIT
TE OF VIRGINIA
LT (COUNTY OP 00... ccccccccccscsscccccessssseceees
The petitioner being duly sworn, says:
1. He is unable to pay the costs of this action «
therefor ;
2. His assets amount to a total of $...........ccccccceseees
Signature of
cribed and sworn to before me
Jeseveseeee day Of ..........ccceeey LO. ..000000
Notary Public
OMMISSION EXPITLES ..............cccecsessssssssssssssseees