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Persons In Custody

Rule 183

KSA 60-1507 Motion

(12/1/06)

IN THE DISTRICT COURT OF

COUNTY, KANSAS

PERSONS IN CUSTODY

Full name of Movant

Prison Number

Case No.:

(To be supplied by the Clerk of the District Court)

vs.

STATE OF KANSAS, Respondent.

INSTRUCTIONS--READ CAREFULLY

In order for this motion to receive consideration by the District Court, it shall be in writing

(legibly handwritten or typewritten), signed by the petitioner under penalty of perjury, and it shall

set forth in concise form the answers to each applicable question. If necessary, petitioner may

finish his or her answer to a particular question on the reverse side of the page or on an

additional blank page. Petitioner shall make it clear to which question any such continued

answer refers.

Since every motion must be subscribed as true under penalty of perjury, any false

statement of a material fact therein may serve as the basis of prosecution and conviction for

perjury. Petitioners should therefore exercise care to assure that all answers are true and

correct.

If the motion is taken in forma pauperis, it shall include (attached at the back of the

form):

an affidavit evidencing petitioner’s inability to pay the full costs of the

proceedings; and

a certified statement setting forth the lesser of the average account balance or

total deposits in petitioner’s inmate trust fund for the six-month period preceding

the filing of the motion or the current period of incarceration, whichever is shorter.

The court will determine the initial fee to be assessed for filing the action, but in no event

will the court require an inmate to pay less than $3. The poverty affidavit applies only to the

amount that must be paid to file the case and does not prevent the court from later assessing

the remainder of the docket fee or other fees and costs against the petitioner.

When the motion is completed, the original and one copy shall be mailed to the Clerk

of the District Court from which petitioner was sentenced.

Persons In Custody