Form 13 (ISLAMIC FAMILY LAW (FORMS AND FEES) RULES 2003

M.P.U. 20/2003
ISLAMIC FAMILY LAW (FORMS AND FEES) 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: ...................................................................................................... Method of marriage: ...................................................................................................

3. We have ...................................................................... children:

(1) ....................................................................... age .......................male/female*

(2) ....................................................................... age .......................male/female*

(3) ....................................................................... age .......................male/female*

(4) ....................................................................... age .......................male/female*

(5) ....................................................................... age .......................male/female*

(6) ....................................................................... age .......................male/female*

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

5. Reasons for fasakh:

..........................................................................................................................

6. State jointly earned property (harta sepencarian) to be claimed by/given to* the wife/ husband* .......................................................................................................................................................................................................................................

7. Provision as to the care and custody of the children .....................................................................................................................................................................................................................................................................................................

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

....................................
(Applicant’s Signature)

(*) Delete whichever is not necessary.