K. P.U. 2/1984
KAEDAH KELUARGA ISLAM (BORANG DAN BAYARAN) 1983
BORANG 14
BORANG 14
NEGERI KEDAH
ENAKMEN KELUARGA ISLAM, 1979
PERMOHONAN PENDAFTARAN PERCERAIAN
(Seksyen 40)
Pendaftar,
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......................................................................
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PERMOHONAN
1. Saya ..........................................................................................................................................
2. No. Kad Pengenalan ....................................................................................................................
3. Alamat .......................................................................................................................................
yang telah bernikah dengan -
4. Nama .........................................................................................................................................
5. No. Kad Pengenalan ....................................................................................................................
6. Alamat .......................................................................................................................................
7. Bil. Sijil Nikah..............................................................................................................................
8. Memohon pendaftaran perceraian itu .............................................................................................
dari ................................................................................................................................................
Bersama ini disertakan Ikrar dan salinan Sijil Pernikahan itu.
Bertarikh ....................................... 19 ...........
Bersamaan .................................... 14 ...........
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Tandatangan Pemohon/ Cap Ibu Jari
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