PARTUMPOLON / PAMASUMASUON (F.

03)

FORMULIR PENDAFTARAN
PERJANJIAN NIKAH (PARTUMPOLON) & PEMBERKATAN NIKAH (PAMASUMASUON)

1. Nama Calon Pengantin Pria : ...........................................................................................................

Tempat/Tanggal Lahir : ...........................................................................................................
Tanggal Baptis : ...........................................................................................................
Tanggal Sidi : ...........................................................................................................
Ruas/Jemaat : ...........................................................................................................
Nama Bapak : ...........................................................................................................
Nama Ibu : ...........................................................................................................
Alamat Rumah : ...........................................................................................................
...........................................................................................................
Telp : ...................................... HP : ...........................................
2. Nama Calon Pengantin Wanita : ...........................................................................................................
Tempat/Tanggal Lahir : ...........................................................................................................
Tanggal Baptis : ...........................................................................................................
Tanggal Sidi : ...........................................................................................................
Ruas/Jemaat : ...........................................................................................................
Nama Bapak : ...........................................................................................................
Nama Ibu : ...........................................................................................................
Alamat Rumah : ...........................................................................................................
...........................................................................................................
Telp : ...................................... HP : ...........................................

Perjanjian Nikah (Partumpolon) dijadwalkan pada hari ............................... Tanggal .............................................. Jam
................. di gereja ...........................................................................
Pemberkatan Nikah (Pamasumasuon) dijadwalkan pada hari ............................... Tanggal ................................... Jam
................. di gereja ...........................................................................

Cinere, ................................................
Menyetujui,
Uluan Ni Huria Sintua Sektor Yang mendaftarkan

Pdt. Tulus Ompusunggu, M.Th (...................................................) (...................................................)

Kelengkapan Administrasi : (diisi oleh Sekretariat)

1. Surat Keterangan keanggotaan jemaat gereja asal calon pengantin (jika bukan jemaat HKBP Cinere) [ ]
2. Fotocopy Akte Baptis calon pengantin Pria [ ]
3. Fotocopy Akte Baptis calon pengantin Wanita [ ]
4. Fotocopy Akte Menyaksikan Iman (Sidi) calon pengantin Pria [ ]
5. Fotocopy Akte Menyaksikan Iman (Sidi) calon pengantin Wanita [ ]
6. Pas photo ukuran 6 x 4 berdampingan, berwarna : 2 lembar [ ]