Form 13 (MARRIAGE AND DIVORCE (FEES AND FORMS) RULES 2003

Kn. P.U. 29/2003
MARRIAGE AND DIVORCE (FEES AND FORMS) RULES 2003

Form 13

(Section 53)
APPLICATION FOR FASAKH

No.: ........................................

To the Registrar of Syariah Court:

1. I, ............................................................................................................................ Identity Card No.: .............................................................. Age: ......................... Address: .................................................................................................................. Occupation:............................................................................................................ Income per month: ................................................................................................ apply for an order for the dissolution of marriage (fasakh) with my husband
named.................................................................................................................................................................................................................................................... Identity Card No.: ............................................................. Age: ......................... Address: .................................................................................................................. Occupation: ....................................................Income per month: .......................

2. Date of marriage: A.H/A.D. ................................. Registration No.: ..................... Place of marriage: .................................................................................................. Period of marriage: ................................................................................................ Method of marriage: ..............................................................................................

3. We have/have not been divorced//ruju’* on .......................................................... No of talaq ...........................................................................................................

4. Reasons for fasakh:
...............................................................................................................................
...............................................................................................................................
...............................................................................................................................

Dated: A.H/A.D. .......................................

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(Applicant’s Signature)

(*) Delete whichever is not necessary.