Application For Post-Conviction Relief
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STATE OF SOUTH CAROLINA
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IN THE COURT OF COMMON PLEAS
County of __________________________
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__________________________________
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Full name and prison number (if any) of Applicant
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v.
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APPLICATION FOR
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State of South Carolina
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POST-CONVICTION RELIEF
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INSTRUCTIONS B READ CAREFULLY
In order for this application to receive consideration by the Court, it shall be in writing (legibly
handwritten or typewritten), signed by the applicant and verified (notarized), and it shall set forth in
concise form the answers to each applicable question. If necessary, applicant may furnish his answer to a
particular question on the reverse side of the page or on an additional page. Applicant shall make clear to
which question any such continued answer refers.
Since every application must be sworn under oath, any false statement of a material fact therein
may serve as the basis of prosecution and conviction for perjury. Applicants should, therefore, exercise
care to assure that all answers are true and correct.
If the application is taken in forma pauperis, it shall include an affidavit (attached at the back of
the form) setting forth information which establishes that applicant will be unable to pay the fees and
costs of the proceedings. When the application is completed, the original shall be mailed to the Clerk of
Court for the County in which the applicant was convicted.
1.
Place of detention ________________________________________________________
_______________________________________________________________________
2.
Name and location of Court which imposed sentence ____________________________
_______________________________________________________________________
3.
Name(s) of co-defendant(s) (if any)
4.
The indictment number or numbers (if known) upon which and the offenses for which
sentence was imposed:
(a)
_________________________________________________________________
(b)
_________________________________________________________________
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