NEGARA BRUNEI DARUSSALAM SURAT PENGAKUAN - Judiciary

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S.D. No.

NEGARA BRUNEI DARUSSALAM

SURAT PENGAKUAN

STATUTORY DECLARATION

Saya, I, ____________________________________________________________________________________________________

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dengan sesungguhnya dan ikhlasnya mengaku bahawa : ___________________________________________________________ do solemnly and sincerely declare that

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________________________________________________________________________________________________________ _________________________________________________________________________________ _______________________

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Saya membuat pengakuan ini dengan tulus ikhlas serta mempercayai bahawa semuanya betul dan benar mengikut kandungankandungan Akta Surat-Surat Sumpah (Penggal 12).

I make this solemn declaration conscirentiously believing the same to be true and virtue of the provisions of the Statutory Declaration Act (Cap 12).

Diperturunkan dan diakui oleh yang Described and solemnly declared

tersebut namanya di atas ini by the abovenamed : _________________________________

__________________________________________________

__________________________________________________ di at : _______________________________________________

di dalam Negara Brunei Darussalam pada in Brunei Darussalam this : ___________________________

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(Tandatangan orang yang membuat Pengakuan) (Signature of Declarant)

haribulan day of : _________________________________20________

Di hadapan saya, Before me,

_________________________________________________ Majistret / Magistrate

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