I, the undersigned First Name Last Name(date of birth Date ) give authority to First Name Last Name to Please Select divorce my wife divorce me from my husband First Name Last Name (date of birth Date ), a Please Select Talaq Raj’i Talaq Khul’i in accordance with Islamic law.
I confirm that MRS Consultants have offered us mediation in an effort to achieve reconciliation.
On completion of the divorce, I agree to settle all outstanding payments due to MRS Consultants.
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