JADUAL KELIMA - BORANG 5C. (ENAKMEN KELUARGA ISLAM 1983

ENAKMEN 1 TAHUN 1983
ENAKMEN KELUARGA ISLAM 1983

JADUAL KELIMA - BORANG 5C.

BORANG 5C

NEGERI KELANTAN

ENAKMEN KELUARGA ISLAM 1983

(Seksyen 42 (1) )

DAFTAR CERAI

1. Bilangan daftar .......................................................

2. Tarikh daftar ............................................................

3. Tarikh Perceraian .......................................... Tarikh akadnikah ...............................................

Bilangan Daftar Nikah ..................................................

4. Tempat .................................... Mukim .............................. Daerah ........................................

Negeri ........................................................................

5. Talak kali .................................. bayaran tebus talak ................................................ Penerima tebus talak .....................................................

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Orang yang dikehendaki

Nama

No. Kad Pengenalan

Umur

Bangsa

Pekerjaan

Alamat

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6. Lelaki
______________________________________________________________________________________

7. Perempuan
______________________________________________________________________________________

8. Saksi (1)
______________________________________________________________________________________

Saksi (2)
______________________________________________________________________________________

9. Pendaftar
______________________________________________________________________________________

10. Perintah Mahkamah ...............................................................................

11. Lain-lain kenyataan ................................................................................

(Meteri)

Tarikh ...............................

...............................
Tandatangan Pendaftar

Disahkan oleh .........................................................