JADUAL PERTAMA (Borang 14) (KAEDAH-KAEDAH UNDANG-UNDANG PENTADBIRAN KELUARGA ISLAM (BORANG DAN FEE) 1987

Tr. P.U.10/87
KAEDAH-KAEDAH UNDANG-UNDANG PENTADBIRAN KELUARGA ISLAM (BORANG DAN FEE) 1987

JADUAL PERTAMA (Borang 14)

BORANG 14

ENAKMEN UNDANG-UNDANG PENTADBIRAN KELUARGA ISLAM 1985

(Seksyen 51(5))

SURAT PERAKUAN CERAI

No. ................................................................
No. Sijil Perakuan Nikah .........................................
No. Permohonan Cerai ...........................................
Nama Suami .............................................................
No.Kad Pengenalan ................................................
Alamat .......................................................
Umur ........................................................ Pekerjaan.........................................................
Nama isteri .........................................................................
No.Kad Pengenalan .........................................
Alamat ...................................................................................
Umur ............................................................... Pekerjaan ............................................................
Tarikh perkahwinan H/M .............................................................................................................
Nama saksi (1) ...............................................................................
No.Kad Pengenalan ......................................................................
Cara bercerai ................................................................................. Talaq kali ....................................................................
Bayaran tebus talaq (jika ada) .......................................................................
Tempat bercerai ................................................................................................
Tarikh bercerai : H/M .........................................................................................
Cerai dalam suci/haid/mengandung* ...........................................................
Nafkah dalam 'iddah .........................................................................................
Nafkah anak ........................................................................................................
Mut'ah ...................................................................................................................
Penyelesaian harta, dsb. ..................................................................................

Tarikh: H/M ..............................................................

(METERAI)

..........................................
Tandatangan Ketua Pendaftar

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* Potong mana yang tidak berkenaan.