SUBORDINATE COURTS OF THE REPUBLIC OF SINGAPORE

COMPLAINT UNDER SECTION 151 CRIMINAL PROCEDURE CODE CHAPTER 68

[Rev Ed] [2012]

FOR OFFICIAL USE:
Case No:
Mediation Date and Time:
Related Case No.:
Nature of Application: / BREACH of syariah court order
Type of Breach: / [ ] Iddah and Mutaah (pre 1999 Amendments)
[ ] Custody of the child(ren)
[ ] Access to the child(ren)
[ ] Matrimonial Assets
[ ] Others ______
Complainant's Name:
ID No.:
Address:
Contact No.:
Respondent's Name:
ID No.:
Address for Service: / (1)
(2)


APPLICATION FOR BREACH OF SYARIAH COURT ORDER

Particulars of Parties (as furnished by the complainant) and children

Complainant Details

Name :
ID (NRIC/FIN/Passport No.) : / ID Type:
Date of Birth (dd/mm/yyyy) :
Address Type : / LOCAL / FOREIGN / Confidential: / YES / NO
Address:
Contact No.: / (Tel) / (Office)
(Handphone) / (Pager)
Nationality: / Religion:
Race:
Educational Qualification :
Language Spoken:
Occupation:
Relationship: / The Complainant is the / of the Respondent.
If the Complainant is or has been married to the Respondent, please
a) enter date and place of marriage : / (dd/mm/yyyy)
at
b) enter date and place of divorce:

Name

The name of the beneficiary (i.e. the person for whom the complainant is making the application) /

Relationship

The complainant is the (please select below) of the beneficiary /
Sex
/
ID
/
DOB
(dd/mm/yyyy) /
Occupation
/
Solicitor (if any):
Name :
Firm :
Contact No.: / (Tel) / (Fax)
File Ref No.:


Respondent Details

Name :
ID (NRIC/FIN/Passport No.) : / ID Type:
Date of Birth (dd/mm/yyyy) :
Address Type : / LOCAL / FOREIGN
Address:
Contact No.: / (Tel) / (Office)
(Handphone) / (Pager)
Nationality: / Religion:
Race:
Educational Qualification :
Language Spoken:
Occupation:
Related Case No / 1) / 2)
3) / 4)
(State the case number of the application filed by the Respondent against the Complainant, if any)
Solicitor (if any):
Name :
Firm :
Contact No.: / (Tel) / (Fax)
File Ref No.:
Children Details (to be completed if the Complainant and Respondent have children)
Name /
Sex
/
ID
/ DOB
(dd/mm/yyyy) / Occupation

Particulars of the Complaint

The complainant being examined on oath states :-

1. / Under the Syariah Order No. ______,
[ NA ] The Respondent is to pay the sum of $______for Iddah.
[ NA ] The Respondent is to pay the sum of $______for Mutaah.
[ ] The Respondent did not comply with the Syariah Court Order on the
Issues of :-
[ ] Iddah and Mutaah
[ ] Custody of the child(ren)
[ ] Access to the child(ren)
[ ] Matrimonial Assets
2. / Brief details of breach:-
6. / I have not lodged any previous application relating to the same matter.
Signature of Complainant
Sworn/Affirmed before me / Interpreted/attended to by
Name & Signature of JO / Name & Signature of Interpreter
District Judge/Magistrate / Language: ______
7. / I confirm that the information I have given for this application is true and correct.


Order by the Court:

Under Section 51 / Section 52 of the Administration of Muslim Law (Amendment) Act 1999, I hereby direct

( ) Issue Notice to the Respondent to attend First Mediation.

( ) Registry to ascertain the address of the Respondent.

( ) Registry to issue Order to Bring Up Prisoner for the Respondent's attendance.

( ) Police to Investigate.

( ) Complaint is dismissed. No offence disclosed.

Name & Signature of JO
District Judge/Magistrate
Application No.: / Date/Time printed :
Page No: 5