FIRST SCHEDULE (Form 2) (MARRIAGE, DIVORCE AND RUJU' (STATE OF PENANG)

Pg. P.U. 5/2000
MARRIAGE, DIVORCE AND RUJU' (STATE OF PENANG)
RULES 2000

FIRST SCHEDULE (Form 2)

FORM 2

(Rule 4)

APPLICATION TO MARR Y FOR FEMALE

A. PARTICULARS OF APPLICANT (FEMALE)

1. Name . …………………………………………………………………………………

2. I.C/Passport No ………………………….3. Date of Birth . ……………………….

4. Address . ………………………………………………………………………………

5. Race ………………………………………6. Nationality . ………………………….

7. Qualification ……………………………..8. Occupation …………………………...

9. Income 10. …………… Date of Conversion to Islam (ifany) ……………………..

11. Tel.No.: ………………………………………………………………………………

B. PARTICULARS OF BRIDEGROOM

I. Name . …………………………………………………………………………………

2. I.C/Passport No ………………………..3. Date of Birth . ………………………..

4. Address ……………………………………………………………………………….

5. Race …………………………………..... 6. Nationality …………………………..

7. Qualification …………………………… 8. Occupation ………………………….

9. Income . …….............. 10. Date of Conversion to Islam (if any) ………………

11. Tel. No.: . …………………………………………………………………………..

C. PARTICULARS OF WALI

1. Name ...........................................................................................................................

2. I.C/Passport No. .................................... 3. Relationship ......................................

4. Age: .......................................................... Address ..................................................

I do hereby solemnly affirm that all the particulars in this form are true and if any of the particulars is found false I have committed an offence punishable under section 38 of the Islamic Family Law (State of Penang) Enactment 1985.

Date: . ………………………………..

………………………………………..
Signature of Wali

D. PARTICULARS OF MARRIAGE

1. Proposed date of marriage . ……………………………………………………….

2. Address ………………………………………………………………………………

E. AFFIRMATION OF APPLICANT

1. I do hereby solemnly affirm that I am still anak dara /janda/widow/*.

2. Divorce Certificate No. (Janda) ………………………………………………..

3. I do hereby solemnly affirm that all the above particulars are true and if any of the particulars is false I have committed an offence punishable under section 38 of the Islamic Family Law (State of Penang) Enactment 1985.

Date: . ………………………………..

………………………………………..
Signature of Applicant

E. *AFFIRMATION OF WITNESS ("JAWATANKUASA KARIAH" "PEGAWAI MASJID"/ISLAMIC AFFAIRS OFFICER) (For Muallaf Only) OR EMBASSY (Non Citizen)

1. Affirmation by two witnesses ("Jawatankuasa Kariah"/"Pegawai Masjid"/Islamic Affairs Officer) that all the particulars in this form are true.

1.1 Witness 1

Name ......................................... I/C. No. ....................................................................

Address ........................................................................................................................

Date ........................................... Signature/Stamp ...................................................

1.2 Witness 2

Name ......................................... I/C. No. ....................................................................

Address ........................................................................................................................

Date ........................................... Signature/Stamp ...................................................

Affirmation by Embassy of ................................................................ that all particulars in this form are true and that there is no restriction for the applicant to get married
in Malaysia.

Date: . ………………………………..

………………………………………..
Signature and Official Stamp

G. STATEMENT BY ASSISTANT REGISTRAR
(except for non-citizen)

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

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

Date: . ………………………………..

………………………………………..
Signature and Official Stamp

FOR OFFICE USE

This application is ............................................. Approved/Not Approved

Date: . ………………………………..

………………………………………..
Signature of Registrar

*Delete whichever is flot applicable.