NO:

IN THE

SUPREME COURT OF THE UNITED STATES

*,

Petitioner,

v.

UNITED STATES OF AMERICA,

Respondent.

On Petition for Writ of Certiorari to the

United States Court of Appeals

for the Eleventh Circuit

PETITION FOR WRIT OF CERTIORARI

ATTORNEY

STREET ADDRESS

CITY, STATE ZIP

Telephone

QUESTION PRESENTED FOR REVIEW

INTERESTED PARTIES

There are no parties to the proceeding other than those named in the caption of the case.

TABLE OF CONTENTS

QUESTION PRESENTED FOR REVIEW	i

INTERESTED PARTIES	ii

TABLE OF AUTHORITIES	iv

PETITION	1

OPINION BELOW	2

STATEMENT OF JURISDICTION	2

STATUTORY AND OTHER PROVISIONS INVOLVED. . . . . . . . .	2

STATEMENT OF THE CASE	3

REASONS FOR GRANTING THE WRIT	4

*	4

CONCLUSION	5

APPENDIX

Decision of the Court of Appeals for the Eleventh Circuit,

United States v. *, *	A-1

Judgment imposing sentence	A-*

TABLE OF AUTHORITIES

CASES:

STATUTORY AND OTHER AUTHORITY:

IN THE

SUPREME COURT OF THE UNITED STATES

No:

*,

Petitioner

v.

UNITED STATES OF AMERICA,

Respondent.

On Petition for Writ of Certiorari to the

United States Court of Appeals

for the Eleventh Circuit

PETITION FOR WRIT OF CERTIORARI

* respectfully petitions the Supreme Court of the United States for a writ of certiorari to review the judgment of the United States Court of Appeals for the Eleventh Circuit, rendered and entered in case number * in that court on * 200*, United States v. *, which affirmed the judgment and commitment of the United States District Court for the Southern District of Florida.

OPINION BELOW

A copy of the decision of the United States Court of Appeals for the Eleventh Circuit, which affirmed the judgment and commitment of the United States District Court for the Southern District of Florida, is contained in the Appendix (A-1).

STATEMENT OF JURISDICTION

Jurisdiction of this Court is invoked under 28 U.S.C. § 1254(1) and Part III of the Rules of the Supreme Court of the United States. The decision of the court of appeals was entered on *, 200*. This petition is timely filed pursuant to Sup. Ct. R. 13.1. The district court had jurisdiction because petitioner was charged with violating federal criminal laws. The court of appeals had jurisdiction pursuant to 28 U.S.C. § 1291 and 18 U.S.C. § 3742, which provide that courts of appeals shall have jurisdiction for all final decisions of United States district courts.

STATUTORY AND OTHER PROVISIONS INVOLVED

Petitioner intends to rely upon the following constitutional provisions, treaties, statutes, rules, ordinances and regulations:

*

STATEMENT OF THE CASE

REASONS FOR GRANTING THE WRIT

CONCLUSION

Based upon the foregoing petition, the Court should grant a writ of certiorari to the Court of Appeals for the Eleventh Circuit.

Respectfully submitted,

ATTORNEY

Counsel for Petitioner

Miami, Florida

* 200*

A P P E N D I X

APPENDIX

Decision of the Court of Appeals for the Eleventh Circuit,

United States v. *, *	A-1

Judgment imposing sentence	A-*

No:

IN THE

SUPREME COURT OF THE UNITED STATES

*,

Petitioner,

v.

UNITED STATES OF AMERICA,

Respondent.

MOTION FOR LEAVE TO PROCEED IN FORMA PAUPERIS

Petitioner, *, pursuant to Sup Ct. R. 39.1, respectfully moves for leave to file the accompanying petition for writ of certiorari in the Supreme Court of the United States without payment of costs and to proceed in forma pauperis.

Petitioner was previously found financially unable to obtain counsel and Criminal Justice Act counsel was appointed to represent Petitioner pursuant to 18 U.S.C. § 3006A. Therefore, in reliance upon Rule 39.1 and § 3006A(d)(6), Petitioner has not attached the affidavit which would otherwise be required by 28 U.S.C. § 1746.

ATTORNEY

Miami, Florida

* , 200*	STREET ADDRESS

CITY, STATE ZIP

Telephone:

No:

IN THE

SUPREME COURT OF THE UNITED STATES

*,

Petitioner,

v.

UNITED STATES OF AMERICA,

Respondent.

CERTIFICATE OF SERVICE

I certify that on this * day of *, 200*, in accordance with Sup. Ct. R. 29, copies of the (1) Petition for Writ of Certiorari, (2) Motion for Leave to Proceed In Forma Pauperis, (3) Certificate of Service, and (4) Declaration Verifying Timely Filing, were served by U.S. mail upon the United States Attorney for the Southern District of Florida, 99 N.E. 4th Street, Miami, Florida 33132-2111, and upon the Solicitor General of the United States, Room 5614, Department of Justice, 950 Pennsylvania Avenue, N.W., Washington, D.C. 20530-0001.

ATTORNEY

Miami, Florida

* , 200*	STREET ADDRESS

CITY, STATE ZIP

Telephone:

No:

IN THE

SUPREME COURT OF THE UNITED STATES

*,

Petitioner,

v.

UNITED STATES OF AMERICA,

Respondent.

DECLARATION VERIFYING TIMELY FILING

Petitioner, *, through undersigned counsel and pursuant to Sup. Ct. R. 29.2 and 28 U.S.C. § 1746, declares that the Petition for Writ of Certiorari filed in the above-styled matter was placed in the U.S. mail in a prepaid first class envelope, addressed to the Clerk of the Supreme Court of the United States, on the * day of *, 200*, which is prior to the time the petition for writ of certiorari is due on *, 200*.

ATTORNEY

Miami, Florida

* , 200*	STREET ADDRESS

CITY, STATE ZIP

Telephone: