Form 3 (MATRIMONIAL PROCEEDING RULES 1988

Pk. P.U. 17/1988
MATRIMONIAL PROCEEDING RULES 1988

Form 3

ISLAMIC FAMILY LAW ENACTMENT 1984

APPLICATION FOR FASAKH

(Section 49)

No. ........................................................

To the Registrar of Syariah Court.

1. I, .......................................................................................................................................................................................... Identity Card No. ....................................................................................
Age ............................................................. Address ...............................................................................................................................................................................................................................
Occupation ........................................................................................................................................................................ Income per month ....................................................................................
apply for an oder 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*

4. We have / have not been divorced / ruju' * on ................................................................................................ No. of Talaq ......................................................................................................

5. Reasons for Fasakh:
...................................................................................................................................................................................................................................................................................................................

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

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

Dated .......................................

..........................................................
Applicant's Signature

____________________________________________________________________________________________________________________________________
* Delete whichever is not necessary