P.U. (A) 143/87
KAEDAH-KAEDAH PERBICARAAN HAL EHWAL SUAMI ISTERI 1987



JADUAL - Borang 1.
AKTA UNDANG-UNDANG KELUARGA ISLAM
(WILAYAH PERSEKUTUAN) 1984

(Seksyen 47)

PERMOHONAN UNTUK PERCERAIAN

Bil .................................................
1. Saya, ..................................................................................................................................... No. Kad Pengenalan........................................................................ Umur.................................... Alamat ....................................................................................................................................... Pekerjaan................................................................. Pendapatan sebulan.................................... memohon bercerai dengan isteri/suami* saya yang bernama........................................................... No. Kad Pengenalan........................................................................ Umur.................................... Alamat ....................................................................................................................................... Pekerjaan................................................................. Pendapatan sebulan....................................

2. Tarikh kahwin H/M ................................................ Bilangan Pendaftaran ................................. Tempat kahwin............................................................................................................................
Cara perkahwinan........................................................................................................................

3. Kami mempunyai anak seramai ..............................................................................................
4. Kami pernah/belum pernah bercerai/ruju' pada ..........................................................................
Talaq kali ...................................................................................................................................

5. Dia adalah isteri/suami* saya yang ...........................................................................................

6. Prosiding sedang berterusan di mana-mana tempat berkaitan dengan perkahwinan dan permohonan yang sama (jika ada) ....................................................................................................................
Mahkamah ..................................................................................................................................
Tarikh bermula .............................................................................................................................
Nama pihak-pihak ........................................................................................................................
Tarikh bicara ................................................................................................................................
Kedudukan prosiding ....................................................................................................................

7. Sebab-sebab bercerai
...............................................................................................................................................
...............................................................................................................................................

8. Langkah-langkah yang telah diambil untuk mencapai perdamaian (jika ada)
...............................................................................................................................................
...............................................................................................................................................

9. Perjanjian (jika ada)
...............................................................................................................................................
...............................................................................................................................................

10.

(1) nafkah 'iddah sebulan $...............................................( ) bulan; jumlah
$........................

(2) nafkah anak seorang sebulan $ ................................( ) orang; jumlah
$........................

(3) Mut'ah $ ...........................................................................
$........................

(4) mas kahwin tunai/hutang sebulan ...............................
$........................

(5) lain-lain bayaran jika ada $ ............................................
$........................

Jumlah .... .... ...

$

11. Nyatakan harta benda sepencarian yang akan diserahkan kepada/dituntut oleh isteri/suami*

12. Peruntukan bagi pemeliharaan dan penjagaan anak-anak
...............................................................................................................................................

13. Butir-butir perintah yang diminta
...............................................................................................................................................
...............................................................................................................................................

.................................................
Tandatangan pemohon
__________________________________________________
* Potong mana yang tidak berkenaan.




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