Uniform Application For Post-Conviction Relief - State Of Louisiana Supreme Court

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APPENDIX "A" -- UNIFORM APPLICATION FOR POST-CONVICTION RELIEF
UNIFORM APPLICATION FOR POST-CONVICTION RELIEF
__________________________________________
No. _______________________________
NAME OF PETITIONER
(to be filled in by the clerk)
__________________________________________
_______ JUDICIAL DISTRICT
PRISON NUMBER
__________________________________________ PARISH OF _________________________
PLACE OF CONFINEMENT
STATE OF LOUISIANA
vs.
__________________________________________
CUSTODIAN (Warden, Superintendent, Jailor,
or authorized person having custody of
petitioner)
Please Serve CUSTODIAN and ___, DISTRICT ATTORNEY, ______ JUDICIAL DISTRICT, STATE OF
LOUISIANA.
INSTRUCTIONS--READ CAREFULLY
(1) This petition must be legibly written or typed, signed by the petitioner and sworn to before a notary public
or institutional officer authorized to administer an oath. Any false statement of a material fact may serve as the
basis for a criminal prosecution. All questions must be answered concisely in the proper space on the form.
Additional pages are not permitted except with respect to the facts which you rely upon to support your claims
for relief. No citation of authorities or legal arguments are necessary.
(2) Only one judgment may be challenged in a single petition except that convictions on multiple counts of a
single indictment or information may be challenged in one petition.
(3) YOU MUST INCLUDE ALL CLAIMS FOR RELIEF AND ALL FACTS SUPPORTING SUCH
CLAIMS IN THE PETITION.
(4) When the petition is completed, the original must be mailed to the clerk of the district court in the parish
where you were convicted and sentenced.
(5) You must attach official documentation showing your sentence and the crime for which you have been
convicted. You may obtain that documentation from the clerk of court of the district court of the parish where
you were sentenced or from the institution where you are confined. If that documentation is not attached, you
must allege what steps were taken to obtain it.
(6) Petitions which do not conform to these instructions will be returned with a notation as to the deficiency.

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