Form 16 (MARRIAGE AND DIVORCE (FEES AND FORMS) RULES 2003

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

Form 16

(Section 55)
CERTIFICATE OF DIVORCE

Registration of Divorce No.: ......................................................................................... Date of Registration of Divorce: ..................................................................................
Date of Divorce: ................................................. Place of Divorce: ...............................
Registration of Mariage/Ruju’/No.: .............................................................................. Date of Marriage/Ruju’: ................................................................................................

Name of Husband: .............................................................................................................. Identity Card No/Passport No.: .....................................................Age: ........................... Occupation: .................................................................................................................... Address of husband: ................................................................................................................................................................................................................................................

Name of wife: .................................................................................................................. Identity Card No/Passport No.: .....................................................Age: ........................... Occupation: .................................................................................................................... Address of wife: ..........................................................................................................

Name of witness (1): .............................................. Identity Card No.: .........................
Name of witness (2): ............................................... Identity Card No.: ..........................

Method of Divorce: ................................................ Number of talaq: ...........................

Payment of Tebus Talaq (if any): ...................................................................................
Divorce while free from meanstruation/during menstruation/during pregnancy: ....................................................................................................................................

Maintenance during period of ‘Iddah: ........................................................................
Maintenance for chldren: ............................................................................................
Mut’ah: ........................................................................................................................
Settlement of property, etc: ............................................................................

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

..................................................................
(Name and Signature of Chief Registrar)

Dated 3 September 2003.

[JUI. (KN)/PUK/712/14/(24); P.U. Kn. Sulit 666/Jld. 1.]

HAJI ISMAIL BIN GHANI,
Clerk of State Executive Council,
Kelantan