Bangladesh Form No-1601 Page. No.

: 80
Volume No.: 07 TRUE COPY
Date:-14-09-2010 For the Bride/Bridegroom.

NIKAH NAMA
FORM OF NIKAH NAMA AS PRESCRIBED UNDER SECTION 9 OF THE MUSLIM
MARRIAGES AND DIVORCES ( REGISTRATION ) ACT-1974.
( LII OF 1974 )

1. Name of the ward Town, Union, Tahshil, Thana, District, in which the marriage took place:

2. Names of the bridegroom and his father with their respective Residences: Abul Kalam Azad, SON
OF- HOSSAIN ALI, AND MOTHER’S NAME- ANWARA BEGUM,VILLAGE- ITNA, POST
OFFICE- KUNDER PARA , UPAZILA- SHIBPUR, DIST.- NARSINGDI

3. Age of the bridegroom: DATE OF BIRTH- 10-12-1980

4. The names of the bride and her father, with their respective residences: SORNALI AKTER,
DOUGHTIER OF- MD. SHAH ALOM AND MOTHER`S NAME-NURUNNAHAR
BEGUM OF VILLAGE- ADIABAD UTTAR PARA, P.O- RADHAGANJBAZAR, POLICE
STATION- RAIPURA, DISTRICT- NARSINGDI

5. Whether the bride is or maiden, a widow or a divorcee: MAIDEN

6. Age of the bride: DATE OF BIRTH- 10-12-1994

7. Name of the wakil, if any, appointed by the bride, his father’s name and his residence: ABDUL
MOTALIB SON OF- MD. SHAFIUDDIN OF VILLAGE- TELIPARA, POST OFFICE-
KUNDARPARA, UPAZILA- SHIBPUR, DIST.- NARSINGDI

8. The name of the witnesses to the appointment of the bride’s wakil with their father's name, Their
residences and their relationship with the bride:

(1) MD. MAHSIN, SON OF- ZIYAUL HAQUE OF VILLAGE- ADIABAD UTTAR PARA, P.O-
RADHAGANJ BAZAR, POLICE STATION- RAIPURA, DISTRICT- NARSINGDI.

(2) MD. SHAFIULLAH, SON OF- HAFEJ ABUL HASEM OF VILLAGE- ADIABAD
DAKKHINPARA, P.O- ADIABAD, POLICE STATION- RAIPURA, DISTRICT- NARSINGDI.

9. Name of the wakil, if any, appointed by the bridegroom, his father’s name and his residence:

NO

10. The name of the witnesses to the appointment of the bridegroom’s. wakil with their father's name
and their residences:
(1)

(2)

11. Names of the witnesses to the marriage, their father's names and their residences:

(1) ABDUL MOTALIB , SON OF- REJMOT ALI OF VILLAGE- ITNA, POST
OFFICE-KUNDARPARA, UPAZILA- SHIBPUR, DIST.- NARSINGDI.
(2) MD. SAYED ALI , SON OF- MD. NASIR UDDIN OF VILLAGE- ITNA, POST OFFICE-
KUNDARPARA, UPAZILA- SHIBPUR, DIST.- NARSINGDI
12. Date on which the marriage was contracted: Marriage date 08-10-2013
13. Amount of dower: 5,00,000/- (FIVE LAC) Taka Only.
14. How much of the dower is mujjal (prompt) and how much mujjal (deferred):

15. Whether any part on of the dower was paid at the time of marriage. If so how much ?

2,75,000/- (TWO LAC SEVENTY FIVE THOUSAND) TAKA PAID OF ORNAMENTS

16. Whether any property was given in lieu of the whole or any portion of the dower, with
Specification of the sake and it valuation agreed to between parties:

17. Special condition, if any: THE HUSBAND WILL PROVIDE MONTHLY EXPENDITURE
PROPERLY.AS PREVALING GENTLEMENTLY STATUS.
18. Whether the husband has delegated the power of divorce to the wife. If so, under what condition:
YES, THE WIFE HAS GIVEN PERMISSION TO DIVORCE HER HUSBAND; IFTHE HUSBAND
IS OUTSIDE THE HOUSE FOR A LONG TIME, IF THERE IS NOADJUSTMENT
AND HE DOES NOT GIVE MAINTENANCE TO WIFE.
19. Whether the husband’s right of divorce is in any way curtailed: NO

20. Whether any document was drawn up at the time of marriage relating to dower.
Maintenance, etc, if so, contents there of in brief: NO

21. Whether the bridegroom has any existing wife and if so whether he has secured
the permission of the Arbitration Council under the Muslim family Laws Ordinance, 1961, to contract
another: NO

22. Number and date of the communication convoying to the bridegroom the permission of the
arbitration Council to contract another marriage: NO

23. Name and addresses of the person by whom the marriage was solemnized and his father:

RAHMAT ULLAH , FATHER- FAZLUR RAHMAN

24. Date of registration of marriage: 18-10-2013.
25. Registration fee: 5,100/-(FIVE THOUSANDS ONE HUNDRED TAKA ONLY

SD/. MONIR HOSSAIN

Signature of bridegroom or his wakil

SD/. MONIR HOSSAIN

Signature of bride

SD/. MONIR HOSSAIN

Signature of the wakil of the bridegroom.