Form Mc 275 – Fill Out and Use This PDF

INSTRUCTIONS—READ CAREFULLY

•If you are challenging an order of commitment or a criminal conviction and are filing this petition in the Superior Court, you should file it in the county that made the order.

•If you are challenging the conditions of your confinement and are filing this petition in the Superior Court, you should file it in the county in which you are confined.

•Read the entire form before answering any questions.

•This petition must be clearly handwritten in ink or typed. You should exercise care to make sure all answers are true and correct. Because the petition includes a verification, the making of a statement that you know is false may result in a conviction for perjury.

•Answer all applicable questions in the proper spaces. If you need additional space, add an extra page and indicate that your answer is ''continued on additional page."

•If you are filing this petition in the superior court, you only need to file the original unless local rules require additional copies. Many courts require more copies.

•If you are filing this petition in the Court of Appeal in paper form and you are an attorney, file the original and 4 copies of the petition and, if separately bound, 1 set of any supporting documents (unless the court orders otherwise by local rule or in a specific case). If you are filing this petition in the Court of Appeal electronically and you are an attorney, follow the requirements of the local rules of court for electronically filed documents. If you are filing this petition in the Court of Appeal and you are not represented by an attorney, file the original and one set of any supporting documents.

•If you are filing this petition in the California Supreme Court, file the original and 10 copies of the petition and, if separately bound, an original and 2 copies of any supporting documents.

•Notify the Clerk of the Court in writing if you change your address after filing your petition.

Approved by the Judicial Council of California for use under rule 8.380 of the California Rules of Court (as amended effective January 1, 2007). Subsequent amendments to rule 8.380 may change the number of copies to be furnished to the Supreme Court and Court of Appeal.

Page 1 of 6

MC–275

This petition concerns:
			A conviction					Parole
			A sentence					Credits
			Jail or prison conditions					Prison discipline
			Other (specify):
1.	Your name:
2.	Where are you incarcerated?
3.
	Why are you in custody?					Criminal conviction				Civil commitment

Answer items a through i to the best of your ability.

a.State reason for civil commitment or, if criminal conviction, state nature of offense and enhancements (for example, ''robbery with use of a deadly weapon'').

b.Penal or other code sections:

c.Name and location of sentencing or committing court:

d.Case number:

e.Date convicted or committed:

f.Date sentenced:

g.Length of sentence:

h.When do you expect to be released?

i. Were you represented by counsel in the trial court?

Yes

No

If yes, state the attorney's name and address:

MC–275

6.GROUNDS FOR RELIEF

Ground 1: State briefly the ground on which you base your claim for relief. For example, ''The trial court imposed an illegal enhancement.'' (If you have additional grounds for relief, use a separate page for each ground. State ground 2 on page 4. For additional grounds, make copies of page 4 and number the additional grounds in order.)

a.Supporting facts:

Tell your story briefly without citing cases or law. If you are challenging the legality of your conviction, describe the facts on which your conviction is based. If necessary, attach additional pages. CAUTION: You must state facts, not conclusions. For example, if you are claiming incompetence of counsel, you must state facts specifically setting forth what your attorney did or failed to do and how that affected your trial. Failure to allege sufficient facts will result in the denial of your petition. (See In re Swain (1949) 34 Cal.2d 300, 304.) A rule of thumb to follow is, who did exactly what to violate your rights at what time (when) or place (where). (If available, attach declarations, relevant records, transcripts, or other documents supporting your claim.)

b.Supporting cases, rules, or other authority (optional):

(Briefly discuss, or list by name and citation, the cases or other authorities that you think are relevant to your claim. If necessary, attach an extra page.)

MC–275

7. Ground 2 or Ground

(if applicable):

a. Supporting facts:

b. Supporting cases, rules, or other authority:

c.Case number or citation of opinion, if known:

d.Issues raised: (1)

(2)

(3)

10.If your petition makes a claim regarding your conviction, sentence, or commitment that you or your attorney did not make on appeal, explain why the claim was not made on appeal:

11.Administrative review:

a.If your petition concerns conditions of confinement or other claims for which there are administrative remedies, failure to exhaust administrative remedies may result in the denial of your petition, even if it is otherwise meritorious. (See In re Muszalski (1975)

52 Cal.App.3d 500.) Explain what administrative review you sought or explain why you did not seek such review:

MC–275

12. Other than direct appeal, have you filed any other petitions, applications, or motions with respect to this conviction, commitment, or

issue in any court?

Yes If yes, continue with number 13.

No If no, skip to number 15.

13 a. (1) Name of court:

(2)Nature of proceeding (for example, ''habeas corpus petition"):

(3)Issues raised: (a)

(b)

(4)Result (attach order or explain why unavailable):

(5)Date of decision: b. (1) Name of court:

(2)Nature of proceeding:

(3)Issues raised: (a)

(b)

(4)Result (attach order or explain why unavailable):

(5)Date of decision:

c. For additional prior petitions, applications, or motions, provide the same information on a separate page.

14.If any of the courts listed in number 13 held a hearing, state name of court, date of hearing, nature of hearing, and result:

15.Explain any delay in the discovery of the claimed grounds for relief and in raising the claims in this petition. (See In re Swain (1949) 34 Cal.2d 300, 304.)

18. If this petition might lawfully have been made to a lower court, state the circumstances justifying an application to this court:

l, the undersigned, say: I am the petitioner in this action. I declare under penalty of perjury under the laws of the State of California that the foregoing allegations and statements are true and correct, except as to matters that are stated on my information and belief, and as to those matters, I believe them to be true.

Date:

(SIGNATURE OF PETITIONER)