Nikah (Marriage) Certification Application Form

Nikah (Marriage) Certificate Application Form

Personal Information of the Groom

Name of the groom *

Muslim Name

Father’s Name *

Mother’s Name *

Nationality *

Date of Birth *

ID Card Number *

Date of Issue *

Address
(Home Country)

Address
(Japan) *

Phone Number *

Email Address *

Number of Marriages

Muslim *

Personal Information of the Bride

Name of the bride *

Muslim Name

Father’s Name *

Mother’s Name *

Nationality *

Date of Birth *

ID Card Number *

Date of Issue *

Address
(Home Country)

Address
(Japan) *

Phone Number *

Email Address *

Number of Marriages

Muslim *

Civil Marriage Certification Details

Prefecture *

City *

Registration Ward *

Date of Registration *

Certificate Number *

Male Muslim Witness Details

Name of Witness 1

Nationality

Name of Witness 2

Nationality

Al-Mahar

Mutakaddam (Prompt) *

Mutaakhir (Deferred) *

In case whole amount is PROMPT then type 0.

Upload Documents

Proof of Identity * (Passport/ Driving License/ Residence Card/ My Number Card etc.) Accepted formats: JPG, PNG, PDF

Photograph of the Groom *
4cm x 3cm Accepted formats: JPG, PNG, PDF

Photograph of the Bride*
4cm x 3cm Accepted formats: JPG, PNG, PDF

Passport (Mandatory for Foreign Residents) Accepted formats: JPG, PNG, PDF

Declaration*

I, the above named applicant, hereby give Kobe Muslim Mosque Funeral (Janazah) Service my full consent and authority to arrange the funeral service of the deceased person as named above. I also give and appoint Kobe Muslim Mosque to negotiate with any relevant and appropriate departments as deemed necessary for the release and collection of the deceased body.

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