SURAT KETERANGAN MENIKAH

SURAT KETERANGAN MENIKAH

Kami yang bertanda tangan di bawah ini menyatakan bahwa saya :

Nama                          : ......................................................................................................

Tempat Tgl Lahir       : ......................................................................................................

Warganegara             : ......................................................................................................

Agama                        : ......................................................................................................

Alamat                        : ......................................................................................................

                                                  ......................................................................................................

Telah menikah kepada saudari :

Nama                          : ......................................................................................................

Tempat Tgl Lahir       : ......................................................................................................

Warganegara             : ......................................................................................................

Agama                        : ......................................................................................................

Alamat                        : ......................................................................................................

                                                  ......................................................................................................

Oleh karena itu kepada yang bersangkutan di mohon untuk bisa memakluminya, karena surat nikah yang asli masih dalam proses.

---------------------------------------------- Penghulu	..................., .............................. ---------------------------------------------- Wali Nikah
---------------------------------------------- Mempelai Laki-laki	---------------------------------------------- Mempelai Perempuan
---------------------------------------------- Saksi I	---------------------------------------------- Saksi II