Phg. P.U. 9/1988
KAEDAH-KAEDAH PROSIDING HAL EHWAL SUAMI ISTERI 1988
JADUAL
Borang 4
ENAKMEN UNDANG-UNDANG KELUARGA ISLAM 1987.
(Seksyen 55 (5))
SURAT PERAKUAN PERCERAIAN
No ..................
Nombor Surat Perakuan Nikah ............................................
Nombor Permohonan Untuk Perceraian ...............................
Nama Suami ..................................... No. Kad Pengenalan ...............................
Alamat ..........................................................................
Umur .......................... Pekerjaan .............................
Nama Isteri ..................................... No. Kad Pengenalan ...............................
Alamat .........................................................................
Umur .......................... Pekerjaan .............................
Tarikh kahwin H/M ....................................................
Nama saksi (1) ............................ No. Kad Pengenalan .................................
Nama saksi (2) ............................ No. Kad Pengenalan .................................
Cara bercerai ................................ Talaq kali .............................
Bayaran tebus talaq (jika ada) ................................
Tempat bercerai ................................... Tarikh bercerai H/M ............................
Cerai dalam suci/haidh/mengandung* ...................................
Nafkah dalam idah ..............................
Nafkah anak .........................................
Mut'ah ....................................................
Penyelesaian harta, dsb ...............................................
Tarikh : H/M ....................................
.............................................
Tandatangan Ketua Pendaftar
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*Potong mana yang tidak berkenaan
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