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______________________________________________________ ga (FHDY organi nomi)
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_________________________________________________________
(ariza beruvchining familiyasi, ismi, ota ismi)
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_________________________________________________________
(yashash manzili)
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_________________________________________________________ (pasport seriyasi, raqami, qachon, kim tomonidan berilgan)
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ARIZA
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Mening erim (xotinim) ________________________________________________________________________
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(familiyasi, ismi, otasining ismi)
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______________________________________ sudining _______ yil “___” __________________ dagi hukmiga asosan _______ yilga ozodlikdan mahrum qilingan va hozirgi kunda ____________________________________
___________________________________________________________________________ da jazoni o‘tamoqda.
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(jazoni ijro etish muassasasining aniq manzilgohi)
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Nikohdan ajralgandan so‘ng, quyidagi familiyada bo‘lishni xohlayman:
Er (xotin): ____________________________________________
Ilova: ______________________ sudining qonuniy kuchga kirgan hukmi
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__________
imzo
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_______ yil “___” ______________
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Nikohdan ajralishni qayd etish ______ yil _______ oyi ______ kuniga tayinlandi.
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____________________________________________________________________
(arizani qabul qilgan FHDY organi xodimining familiyasi va imzosi)
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