Sel. P.U. 12/89 KAEDAH-KAEDAH PERKAHWINAN, CERAI DAN RUJU' (BORANG DAN FEE) 1989
JADUAL PERTAMA
BORANG 11/FORM 11
(Seksyen/Section 53)
PERAKUAN ANGGAPAN MATI (MAFQUD)
OLEH TUAN ........................................
HAKIM SYARIAH.
Adalah disahkan bahawa orang tersebut di bawah ini telah dianggap mati (Mafqud);
Nama Penuh ....................................................................................................................
No. Kad Pengenalan ............................................ Jantina .................................................
Alamat terakhir .................................................................................................................
Sebab kematian ...............................................................................................................
........................................................................................................................................
Tempat kematian .............................................................................................................
Saksi-saksi yang mengesahkan;
(1) .........................................................................................................................
(No. Kad Pengenalan ...........................)
(2) .........................................................................................................................
(No. Kad Pengenalan ...........................)
Keadaan kematian ...........................................................................................................
.......................................................................................................................................
Tarikh H/M .........................
.................................................... Hakim Syariah