JADUAL PERTAMA - Borang 8 (KAEDAH-KAEDAH KELUARGA ISLAM (BORANG DAN FEE) 1987

P.U. (A) 142/87
KAEDAH-KAEDAH KELUARGA ISLAM (BORANG DAN FEE) 1987

JADUAL PERTAMA - Borang 8

AKTA UNDANG-UNDANG KELUARGA ISLAM (WILAYAH PERSEKUTUAN) 1984

(Seksyen 51 (3))

SURAT PERAKUAN RUJU'

Bilangan Daftar Cerai .................................................................................................Tarikh H/M ........................................
Nama suami ....................................................................................... No. Kad Pengenalan ..............................................
Umur ............................................... Pekerjaan .......................................................................................................................
Nama isteri .......................................................................................... No. Kad Pengenalan ..............................................
Umur ............................................... Pekerjaan .......................................................................................................................
Alamat suami ............................................................................................................................................................................
Alamat isteri ...............................................................................................................................................................................
adalah saya ...............................................................................................................................................................................

(Nama Pendaftar)

memperakui bahawa---

Nama ......................................................................................... meruju' isterinya (nama) ....................................................................................... yang telah mendapat persetujuan dari isterinya dengan lafaz "Saya ruju' akan isteri saya (nama) ........................................................... kepada nikah saya yang dahulu .............................................................................................................................................................................". Bilangan Daftar Nikah ...............................................................................................................................................................
Tarikh perkahwinan H/M ................................................................... Tarikh ruju' H/M ..........................................................
Lain-lain kenyataan ...................................................................................................................................................................
No. Daftar Ruju' ..........................................................................................................................................................................

..............................................	..............................................	..............................................
Tandatangan Suami	Tandatangan Isteri	Tandatangan Pendaftar