SCHEDULE 1 (PEGUAM SYARIE (STATE OF PENANG) RULES 1997

Pg. P.U. 5/1997
PEGUAM SYARIE (STATE OF PENANG) RULES 1997

SCHEDULE 1

ADMINISTRATION OF ISLAMIC RELIGIOUS AFFAIRS
ENACTMENT OF THE STATE OF PENANG 1993

PEGUAM SYARIE(STATE OF PENANG) RULES 1997

Form 1

(Rules 10 and 26)

APPLICATION FORM FOR APPOINTMENT AS A PEGUAM SYARIE

*Fresh Application/Renewal

Chairman,
Peguam SyarieCommittee,
State of Pulau Pinang.

With respect I wish to apply to be appointed as a Peguam Syarie and I furnish below my personal particulars.

(To be completed by applicant in CAPIATAL LETTERS)

1. Name :

2. Other Names (if any) :

3. Sex :

4. Date of Birth :

5. Place of Birth :

6. Single/Married/Other Status :

7. Citizenship :

8. Religion :

9. Identify Card No :

10. Place and Date of Issue :

11. Usual Correspondence Address :

12. Telephone No :

13. Eligibility and Qualification :

I hereby declare that all the information given above a true.

I hereby also declare that I-

(i) have not been convicted in Malaysia or elsewhere of a criminal offence (under any written law) as would render myself unfit to be a

Peguam Syarie,

and in particular, but not limited to an offence involving fraud or dishonesty; or

(ii) have not been adjudicated bankrupt; or

(iii) have not been found guilty of any of the acts or omission mentioned in paragraph 33(6)

(a), (b), (c),

(e), (f), (h), (k)

(l)

of the Bankruptcy Act, 1967.

Date : ...............................................

................................................
Signature

REMINDER

1. Every applicant shall submit two copies of every certificate and other document which must be certified as a true copy and also two copies for every letter of reference.

2. Every copy of a certificate or document must be certified as a true copy by any of the following persons-

(a) a Peguam Syarie;

(b) an advocate or solicitor registered under the Legal Profession Act 1976;

(d) a member of Parliament : or

(e) a Government Officer in Group A.

______________________________________________________________________________________

Delete whichever is not applicable

FOR USE OF THE MAINPP ONLY

Date received :

Recommendation of Peguam SyarieCommittee :

Date of recommendation :

Deferred to the following date :

Reasons for deferment :

Date of decision of MAINPP :

Deferred to the following date :

Reasons for deferment :

Date applicant was informed :

Date when fee for certificate was received :

Receipt No :

Applicant notified of decision on :

Receipt sent to applicant on :

Recorded in the Register of Peguam Syarieon :

Registration Serial No. :