Form 15 (MARRIAGE AND DIVORCE (FEES AND FORMS) RULES 2003

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

Form 15

(Section 54)
CERTIFICATE OF PRESUMPTION OF DEATH

BEFORE TUAN .....................................................
SYARIAH JUDGE

This is to certify that the person mentioned below is presumed dead:

Full name: ................................................................................................................. Identity Card No.: .................................................................... Sex: .......................... Last address: .................................................................................................................. Is presumed dead.

Witnesses certifying:
(1) ........................................... Identity Card No.: ................................................
(2) ........................................... Identity Card No.: ................................................

Circumstances of death: ........................................................................................

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

..................................................
(Syariah Judge)