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MALAYSIA

IN THE HIGH COURT IN SABAH AND SARAWAK AT SIBU


DIVORCE PETITION NO.:_______________________
IN THE MATTER OF SECTION 52 OF THE LAW REFORM
(MARRIAGE AND DIVORCE) ACT 1976
BETWEEN
MEDI ANAK TUMAS, (M) (970910-52-6263)
Tr Sumbang Anak Tayai,
Tembawai Tinting, Ulu Layar,
95700 Betong.

... Husband Petitioner

AND
LIBIA LINA ANAK KETIT, (F) (880107-52-5236)
Tr Ngipa, Sg Buluh,
96500 Bintangor.

... Wife Petitioner

THE JOINT PETITION OF MEDI ANAK TUMAS, (M) AND LIBIA LINA ANAK
KETIT (F) SHOWS THAT :1.

On the 9th day of December, 2008, the Petitioners were lawfully married
to one another according to civil marriage at the National Registration
Department, Bintangor Sarawak.
(Photocopy of Marriage Certificate is annexed herewith and marked A)

2.

After the said marriage the Petitioners have cohabitated in Bintangor.

3.

Both Petitioners herein were born in Sarawak and are domiciled in


Malaysia at the date of presenting the Joint Petition herein.

4.

The Petitioners have agreed that their marriage should be dissolved and
they freely consent thereof.

5.

That there is one (1) adopted child during the said marriage, namely:
(i)

Conellius Stanley Jatan Anak Medi, (m) born on the 9th day of
May, 2014.

The child is under the care, control and custody of the Wife Petitioner.
(Photocopy of the childs Birth Certificate is annexed herewith marked
BC1)
6.

The following provisions have been made for the Wife Petitioner:-

The Petitioners have voluntarily agreed that there shall be no


maintenance to the Wife Petitioner upon pronouncement of the
Decree Nisi.
7.

The following provisions have been made for the support, care and the
custody of the child who is under 16 years of age and is still receiving
education:The Petitioners have agreed that the custody of the children of the
marriage be granted to the Wife Petitioner with reasonable access to the
Husband Petitioner.

8.

There have been no previous proceedings in any court in Malaysia or


elsewhere with reference to the marriage.

9.

There are no proceedings continuing in any country outside Malaysia


which are in respect of the marriage or are capable of affecting its validity
or subsistence.

10.

THE PETITIONERS THEREFORE PRAY:(a)

That the said marriage be dissolved;

(b)

That the care, control and custody of the child of the said marriage,
namely, Conellius Stanley Jatan Anak Medi, (m) shall be granted
to the Wife Petitioner with reasonable access to the Husband
Petitioner.

(c)

With liberty to apply.

It is not intended to serve this Petition on any other person.


The address of service of both the Petitioners shall be care of the Assistant
Director, Legal Aid Department Sibu, Tingkat 10, Wisma Vasty, Lot 445, Jalan
Pulau, 96000 Sibu.

Dated.....................................

..
Husband Petitioner
Legal Aid Department,
Sibu.

.
Wife Petitioner

............................................
Assistant Director,

This Petition is filed by the Assistant Director, Legal Aid Department Sibu, the Advocates for the
Petitioners whose address for service is Tingkat 10 (Section A), WismaVasty, Lot 445, Block 5,
JalanPulau, 96000 Sibu.

MALAYSIA
IN THE HIGH COURT IN SABAH AND SARAWAK AT SIBU
DIVORCE PETITION NO.:_______________________
IN THE MATTER OF SECTION 52 OF THE LAW REFORM
(MARRIAGE AND DIVORCE) ACT 1976
BETWEEN
MEDI ANAK TUMAS, (M) (970910-52-6263)
Tr Sumbang Anak Tayai,
Tembawai Tinting, Ulu Layar,
95700 Betong.

... Husband Petitioner

AND
LIBIA LINA ANAK KETIT, (F) (880107-52-5236)
Tr Ngipa, Sg Buluh,
96500 Bintangor.

AFFIDAVIT

... Wife Petitioner

I, MEDI ANAK TUMAS, (M) (970910-52-6263) of full age, of Tr Sumbang Anak


Tayai, Tembawai Tinting, Ulu Layar, 95700 Betong do hereby solemnly and
sincerely affirm/make oath and say as follows:1.

That I am the Husband Petitioner of the Joint Petition for divorce filed
herein and such I have the knowledge and authority to make this
Affidavit.

2.

I am a Malaysian citizen and domiciled in the state of Sarawak, Malaysia.

3.

I have read through the Joint Petition filed and confirm that the
statements contained in paragraph 1 to 10 of the said Joint Petition are
true.

4.

To the best of my knowledge and reasonable belief the contents of the


Statements as to the Arrangement for Children filed herein are true.

AFFIRMED by the said


.............................................................
at..........................................................
this ......... day of ..................................

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

Before me,

.........................................
Commisioner For Oaths.

This Affidavit is filed by the Assistant Director , Legal Aid Department Sibu, the Advocates for the
Petitioners whose address for service is Tingkat 10 (Section A), WismaVasty, Lot 445, Block 5,
JalanPulau, 96000 Sibu.

MALAYSIA
MALAYSIA
IN THE HIGH COURT IN SABAH AND SARAWAK AT SIBU
DIVORCE PETITION NO.:_______________________
IN THE MATTER OF SECTION 52 OF THE LAW REFORM
(MARRIAGE AND DIVORCE) ACT 1976
BETWEEN
MEDI ANAK TUMAS, (M) (970910-52-6263)
Tr Sumbang Anak Tayai,
Tembawai Tinting, Ulu Layar,
95700 Betong.

... Husband Petitioner

AND
LIBIA LINA ANAK KETIT, (F) (880107-52-5236)
Tr Ngipa, Sg Buluh,
96500 Bintangor.

... Wife Petitioner

AFFIDAVIT AS TO INCOME, ASSETS ETC.


IN SUPPORT OF PETITION FOR DIVORCE
I, MEDI ANAK TUMAS, (M) (970910-52-6263) of full age, of Tr Sumbang Anak
Tayai, Tembawai Tinting, Ulu Layar, 95700 Betong do hereby solemnly and
sincerely affirm/make oath and say as follows:-

1.

That I am the Husband Petitioner of the Joint Petition for divorce filed
herein and such I have the knowledge and authority to make this
Affidavit.

2.

That I am working as a farmer at Tr Sumbang Anak Tayai, Tembawai


Tinting, Ulu Layar, 95700 Betong with monthly income of RM500.00

3.

I do not have any assets or property either movable or immovable.

4.

That I have no other source of income or property upon which I could


depend on.

AFFIRMED by the said


.............................................................
at .........................................................
this ......... day of ..................................

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

Before me,

.........................................
Commisioner For Oaths.

This Affidavit is filed by Assistant Director ofLegal Aid Department Sibu, the Advocates for the
Petitioners whose address for service is Tingkat 10 (Section A), WismaVasty, Lot 445, Block 5,
JalanPulau, 96000 Sibu.

MALAYSIA
IN THE HIGH COURT IN SABAH AND SARAWAK AT SIBU
DIVORCE PETITION NO.:_______________________
IN THE MATTER OF SECTION 52 OF THE LAW REFORM
(MARRIAGE AND DIVORCE) ACT 1976
BETWEEN
MEDI ANAK TUMAS, (M) (970910-52-6263)
Tr Sumbang Anak Tayai,

Tembawai Tinting, Ulu Layar,


95700 Betong.

... Husband Petitioner


AND

LIBIA LINA ANAK KETIT, (F) (880107-52-5236)


Tr Ngipa, Sg Buluh,
96500 Bintangor.

... Wife Petitioner

AFFIDAVIT
I, LIBIA LINA ANAK KETIT, (F) (880107-52-5236) of full age, of Tr Ngipa, Sg
Buluh, 96500 Bintangor do hereby solemnly and sincerely affirm/make oath
and say as follows:1.

That I am the Wife Petitioner of the Joint Petition for divorce filed herein
and such I have the knowledge and authority to make this Affidavit.

2.

I am a Malaysian citizen and domiciled in the state of Sarawak, Malaysia.

3.

I have read through the Joint Petition filed and confirm that the
statements contained in paragraph 1 to 10 of the said Joint Petition are
true.

4.

To the best of my knowledge and reasonable belief the contents of the


Statements as to the Arrangement for Children filed herein are true.

AFFIRMED by the said


..........................................................
at ......................................................
this ....... day of .................................

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

Before me,

.........................................
Commisioner For Oaths

This Affidavit is filed by Assistant Director ofLegal Aid Department Sibu, the Advocates for the
Petitioners whose address for service is Tingkat 10 (Section A), WismaVasty, Lot 445, Block 5,
JalanPulau, 96000 Sibu.

MALAYSIA

IN THE HIGH COURT IN SABAH AND SARAWAK AT SIBU


DIVORCE PETITION NO.:_______________________
IN THE MATTER OF SECTION 52 OF THE LAW REFORM
(MARRIAGE AND DIVORCE) ACT 1976
BETWEEN
MEDI ANAK TUMAS, (M) (970910-52-6263)
Tr Sumbang Anak Tayai,
Tembawai Tinting, Ulu Layar,
95700 Betong.

... Husband Petitioner

AND
LIBIA LINA ANAK KETIT, (F) (880107-52-5236)
Tr Ngipa, Sg Buluh,
96500 Bintangor.

... Wife Petitioner

AFFIDAVIT AS TO INCOME, ASSETS ETC.


IN SUPPORT OF PETITION FOR DIVORCE
I, LIBIA LINA ANAK KETIT, (F) (880107-52-5236) of full age, of Tr Ngipa, Sg
Buluh, 96500 Bintangor do hereby solemnly and sincerely affirm/make oath
and say as follows:1.

That I am the Wife Petitioner of the Joint Petition for divorce filed herein
and such I have the knowledge and authority to make this Affidavit.

2.

That I am working as a salesgirl at Aifah Electrical & General Trading, No.


47, Repok Road, P.O Box 889, 96100 Sarikei with monthly income of
RM800.00

3.

I do not have any assets or property either movable or immovable.

4.

That I have no other source of income or property upon which I could


depend on other than that I have mentioned above.

AFFIRMED by the said


.................................
at .........................................................
this .......... day of .................................

Before me,

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

.........................................
Commisioner For Oaths.

This Affidavit is filed by Assistant Director ofLegal Aid Department Sibu, the Advocates for the
Petitioners whose address for service is Tingkat 10 (Section A), WismaVasty, Lot 445, Block 5,
JalanPulau, 96000 Sibu.

MALAYSIA
IN THE HIGH COURT IN SABAH AND SARAWAK AT SIBU
DIVORCE PETITION NO.:_______________________
IN THE MATTER OF SECTION 52 OF THE LAW REFORM
(MARRIAGE AND DIVORCE) ACT 1976
BETWEEN
MEDI ANAK TUMAS, (M) (970910-52-6263)
Tr Sumbang Anak Tayai,
Tembawai Tinting, Ulu Layar,
95700 Betong.

... Husband Petitioner

AND
LIBIA LINA ANAK KETIT, (F) (880107-52-5236)
Tr Ngipa, Sg Buluh,
96500 Bintangor.

... Wife Petitioner

STATEMENT AS TO ARRANGEMENTS FOR CHILDREN


The present arrangements for the minor child of the family under
16 and those over 16 who are receiving instruction at an educational
establishment or undergoing training for a trade, profession or vocation
are as follows:1.

CONELLIUS STANLEY JATAN ANAK MEDI, (M)

Residence :
He is staying with the Wife Petitioner at Tr Ngipa, Sg Buluh, 96500
Bintangor.
Education:
He is not attending school yet.

Financial Provision:
The Husband Petitioner and Wife Petitioner are supporting her and are paying for
her up keep.

Access:
That on the dissolution of the said marriage, the Wife Petitioner shall have
the care control and custody of the said child whereas the Husband
Petitioner shall have reasonable access to the said child.
The arrangements proposed for the said child in event of decree
being granted are as follows:(i)

(ii)

(iii)

In the event of decree being granted, it is not proposed to alter


the present arrangement and/or agreement in respect of the
residence, education, financial provision for the said child.
The said child is not suffering from any serious disability or
chronic illness or from the effect of any serious illness.
(Photocopy of the Medical Report is annexed hereto and
marked as MR1)
The said child is not under the care of Welfare Officer or
Officer appointed by local authority or other persons or
organizations.

Dated this.................................

.........................................
Assistant Director,
Legal Aid Department,
Sibu.

This Arrangement is filed by the Assistant Director, Legal Aid Department Sibu, the
Advocates for the Petitioners whose address for service is Tingkat 10, WismaVasty, Lot
445, JalanPulau, 96000 Sibu.

BORANG IV
AKTA BANTUAN GUAMAN 1971
PERAKUAN BANTUAN GUAMAN
Setelah menimbangkan permohonan yang dibuat oleh ENCIK MEDI ANAK
TUMAS, (M) yang beralamat di Tr Sumbang Anak Tayai, Tinting, Ulu Layar,
95700 Betong untuk diberi Bantuan Guaman di bawah Akta Bantuan Guaman,

1971, maka saya memperakui

bahawa ENCIK MEDI ANAK TUMAS, (M)

tersebut di atas adalah berhak kepada Bantuan Guaman di bawah Akta tersebut.
Bantuan Guaman diberi bagi maksud:
PEMBUBARAN PERKAHWINAN
Di Sibu pada

.............................................
b.p. Ketua Pengarah,
Jabatan Bantuan Guaman,
MALAYSIA.
...................................................................................................................................
CATATAN
Saya telah mempertugaskan Encik Nor Kamal Bin Kassim/Encik Jong Foh
Tsin dari Jabatan Bantuan Guaman Sibu beralamat di Tingkat 10, Wisma
Vasty, Lot 445, Jalan Pulau, 96000 Sibu untuk bertindak sebagai Peguam bagi
pihak orang yang dibantu oleh yang tersebut dalam Perakuan ini.
Bertarikh pada

..............................................
b.p. Ketua Pengarah,
Jabatan Bantuan Guaman,
MALAYSIA.
BORANG IV
AKTA BANTUAN GUAMAN 1971
PERAKUAN BANTUAN GUAMAN
Setelah menimbangkan permohonan yang dibuat oleh PUAN LIBIA LINA ANAK
KETIT, (F) yang beralamat di Tr Ngipa, Sg Buluh, 96500 Bintangor untuk diberi
Bantuan Guaman di bawah Akta Bantuan Guaman, 1971, maka saya
memperakui

bahawa PUAN LIBIA LINA ANAK KETIT, (F) tersebut di atas

adalah berhak kepada Bantuan Guaman di bawah Akta tersebut.


Bantuan Guaman diberi bagi maksud:
PEMBUBARAN PERKAHWINAN
Di Sibu pada

.............................................
b.p. Ketua Pengarah,
Jabatan Bantuan Guaman,
MALAYSIA.
...................................................................................................................................
CATATAN
Saya telah mempertugaskan Encik Nor Kamal Bin Kassim/Encik Jong Foh
Tsin dari Jabatan Bantuan Guaman Sibu beralamat di Tingkat 10, Wisma
Vasty, Lot 445, Jalan Pulau, 96000 Sibu untuk bertindak sebagai Peguam bagi
pihak orang yang dibantu oleh yang tersebut dalam Perakuan ini.
Bertarikh pada

..............................................
b.p. Ketua Pengarah,
Jabatan Bantuan Guaman,
MALAYSIA.
BORANG VIII
AKTA BANTUAN GUAMAN 1971
PERAKUAN BANTUAN GUAMAN
DALAM MAHKAMAH TINGGI SIBU
DALAM NEGERI SARAWAK
DI ANTARA
MEDI ANAK TUMAS, (M) (970910-52-6263)
Tr Sumbang Anak Tayai,
Tembawai Tinting, Ulu Layar,
95700 BETONG
...
Suami

Pempetisyen

DAN
LIBIA LINA ANAK KETIT, (F) (880107-52-5236)
Tr Ngipa, Sg Buluh,
96500 BINTANGOR
... Pempetisyen Isteri

ADALAH

DIBERITAHU

bahawa

Perakuan

Bantuan

Guaman

bertarikh

____________________ telah dikeluarkan kepada ENCIK MEDI ANAK


TUMAS, (M) tersebut di atas berkenaan dengan perbicaraan yang berikut:
PEMBUBARAN PERKAHWINAN
SELANJUTNYA ADALAH DIBERITAHU oleh yang demikian ENCIK MEDI
ANAK TUMAS, (M) tersebut adalah dan telah menjadi seorang yang dibantu
dalam perbicaraan itu mulai dari tarikh itu.

Bertarikh pada
.........................................
b.p. Ketua Pengarah,
Jabatan Bantuan Guaman,
MALAYSIA.

BORANG VIII
AKTA BANTUAN GUAMAN 1971
PERAKUAN BANTUAN GUAMAN
DALAM MAHKAMAH TINGGI SIBU
DALAM NEGERI SARAWAK
DI ANTARA

MEDI ANAK TUMAS, (M) (970910-52-6263)


Tr Sumbang Anak Tayai,
Tembawai Tinting, Ulu Layar,
95700 BETONG
...
Suami
DAN
LIBIA LINA ANAK KETIT, (F) (880107-52-5236)
Tr Ngipa, Sg Buluh,

Pempetisyen

96500 BINTANGOR

ADALAH

DIBERITAHU

... Pempetisyen Isteri

bahawa

Perakuan

Bantuan

Guaman

bertarikh

____________________ telah dikeluarkan kepada PUAN LIBIA LINA ANAK


KETIT, (F) tersebut di atas berkenaan dengan perbicaraan yang berikut:
PEMBUBARAN PERKAHWINAN
SELANJUTNYA ADALAH DIBERITAHU oleh yang demikian PUAN LIBIA LINA
ANAK KETIT, (F) tersebut adalah dan telah menjadi seorang yang dibantu
dalam perbicaraan itu mulai dari tarikh itu.

Bertarikh pada
..........................................
b.p. Ketua Pengarah,
Jabatan Bantuan Guaman,
MALAYSIA.

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