/akn/my/act/pua/2018/3

PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018

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Type: P.U. (A)
Status: In force
Enacted: 2018
Sections: 6

Quick answer

About this p.u. (a)

PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 is Malaysia P.U. (A), cited as P.U. (A) 3 2018, currently marked in force and first recorded in 2018.

Opening note

Preamble

PADA menjalankan kuasa yang diberikan oleh perenggan 20(2)(b) Akta Keganasan Rumah Tangga 1994 [Akta 521], Menteri membuat peraturan-peraturan yang berikut: Nama dan permulaan kuat kuasa

Seksyen 1

(1)

Peraturan-peraturan ini bolehlah dinamakan

Peraturan-Peraturan

Keganasan Rumah Tangga (Borang yang Ditetapkan) 2018.

(2)

Peraturan-Peraturan ini mula berkuat kuasa pada 10 Januari 2018.

Borang

Seksyen 2

Borang yang perlu digunakan bagi maksud Akta hendaklah sebagaimana yang dinyatakan dalam Jadual.

Seksyen 3

Peralihan

Apa-apa yang berbangkit daripada permohonan bagi suatu perintah perlindungan interim atau perintah perlindungan yang masih belum selesai di hadapan mahkamah pada tarikh permulaan kuat kuasa Peraturan-Peraturan ini hendaklah diuruskan dengan mengguna pakai borang-borang di bawah Peraturan-Peraturan ini.

Seksyen 4

Pembatalan

[P.U. (A) 60/1999] dibatalkan.

P.U. (A) 3 3

Jadual

JADUAL

[Peraturan 2]

BORANG 1

[Seksyen 3A]

PERMOHONAN BAGI PERINTAH PERLINDUNGAN KECEMASAN

Untuk kegunaan pejabat:

DALAM DAERAH/NEGERI ________________________________________________________________________

NO. DAFTAR KES: ________________________________________________ TAHUN: ______________________

BAHAWASANYA SAYA ______________________________________________________________________

(nama pemohon) *No. Kad Pengenalan/No. Pasport: ______________________________________________

dengan ini membuat permohonan bagi suatu perintah perlindungan kecemasan berkenaan dengan ___________________________________________________________________________ (nama mangsa)

*No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran: __________________________________

terhadap _____________________________________________________________________________________________

(nama orang yang terhadapnya perintah itu diminta) *No. Kad Pengenalan/No. Pasport:

________________________________________________________________________________________________________

Catatan:

Suatu permohonan bagi suatu perintah perlindungan kecemasan hendaklah dibuat oleh—

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 4

No. Daftar Kes: ____________________________________

Perihalan keganasan rumah tangga:

_________________________________________________________________________________________________________

Catatan: Sila nyatakan perihalan keganasan rumah tangga yang berkaitan yang hendaklah termasuk perbuatan keganasan rumah tangga itu, hubungan antara mangsa dengan orang yang terhadapnya perintah itu diminta, dan alamat di mana keganasan rumah tangga itu berlaku atau telah berlaku.

_______________________________

____________________________________________________

(Pemohon) (Pegawai Kebajikan Masyarakat Diberi Kuasa)

P.U. (A) 3 5

No. Daftar Kes: ________________________________

Untuk kegunaan pejabat:

Keputusan Pegawai Kebajikan Masyarakat Diberi Kuasa:

_________________________________________________________________________________________________________

Cop Rasmi

____________________________________________________

(Pegawai Kebajikan Masyarakat Diberi Kuasa)

Tarikh:

P.U. (A) 3 6

BORANG 2

[Seksyen 3A]

PERINTAH PERLINDUNGAN KECEMASAN

PEJABAT KEBAJIKAN MASYARAKAT _______________________________________________________________

DALAM DAERAH _____________________________________________________________________________________

NEGERI _______________________________________________________________________________________________

NO. DAFTAR KES: ______________________________________ TAHUN: ___________________________________

BAHAWASANYA _____________________________________________________________________________

(nama mangsa)

Kad

Pengenalan/No.

Pasport/No.

Sijil

Kelahiran:

____________________________________________________________________________________ yang beralamat di

_________________________________________________________________________________________________________

memerlukan suatu perintah perlindungan kecemasan.

DENGAN INI DIPERINTAHKAN BAHAWA, ____________________________________________________

(nama orang yang terhadapnya perintah ini dibuat)

Kad

Pengenalan/

No. Pasport:______________________________________________________________________ yang beralamat di

_________________________________________________________________________________________________________

dihalang daripada menggunakan keganasan rumah tangga terhadap mangsa dengan bersengaja atau dengan disedarinya meletakkan, atau cuba meletakkan, mangsa itu dalam keadaan ketakutan kecederaan fizikal;

P.U. (A) 3 7

dihalang daripada menggunakan keganasan rumah tangga terhadap mangsa dengan menyebabkan kecederaan fizikal kepada mangsa itu dengan sesuatu perbuatan yang diketahui atau yang sepatutnya diketahui akan mengakibatkan kecederaan fizikal;

dilarang daripada menghasut mana-mana orang lain untuk melakukan keganasan rumah tangga terhadap mangsa dengan bersengaja atau dengan disedarinya meletakkan, atau cuba meletakkan, mangsa itu dalam keadaan ketakutan kecederaan fizikal;

dilarang daripada menghasut mana-mana orang lain untuk melakukan keganasan rumah tangga terhadap mangsa dengan menyebabkan kecederaan fizikal kepada mangsa itu dengan sesuatu perbuatan yang diketahui atau yang sepatutnya diketahui akan mengakibatkan kecederaan fizikal;

dilarang daripada memasuki tempat selamat, tempat berlindung, tempat kediaman, kediaman bersama atau kediaman alternatif mana-mana orang dilindungi.

Perintah perlindungan kecemasan ini hendaklah sah selama tempoh tujuh hari dari tarikh pengeluaran perintah ini dan berkuat kuasa apabila salinan perintah ini disampaikan kepada

_________________________________________________________________________________________________________

(nama orang yang terhadapnya perintah ini dibuat).

Cop Rasmi

_____________________________________________

(Pegawai Kebajikan Masyarakat Diberi Kuasa)

Tarikh:

Catatan:

Perintah ini hendaklah dilengkapkan dalam tiga salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 8

BORANG 3

[Seksyen 4]

PERINTAH PERLINDUNGAN INTERIM

NEGERI _____________________________, MALAYSIA

DALAM MAHKAMAH _________________________________________ DI ___________________________________

NO. PERMOHONAN: _________________________________________________________________________________

NO. LAPORAN POLIS: ________________________________________________________________________________

BAHAWASANYA _____________________________________________________________________________

(nama orang dilindungi) *No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran:

____________________________________________________________________________________ yang beralamat di

_________________________________________________________________________________________________________

hadir di dalam mahkamah ini dan bahawasanya mahkamah, setelah membaca permohonan itu, berpuas hati bahawa beliau memerlukan suatu perintah perlindungan interim sementara menunggu penyiasatan yang berhubungan dengan pelakuan suatu kesalahan yang melibatkan keganasan rumah tangga yang telah dilakukan terhadapnya.

DENGAN INI DIPERINTAHKAN BAHAWA, _________________________________________________________

(nama orang yang terhadapnya perintah ini dibuat)

Kad

Pengenalan/

No. Pasport: ________________________________________________________________ yang beralamat di

_________________________________________________________________________________________________________

P.U. (A) 3 9

dihalang daripada menggunakan keganasan rumah tangga terhadap orang dilindungi itu;

dilarang daripada menghasut mana-mana orang lain untuk melakukan keganasan rumah tangga terhadap orang dilindungi itu.

Mahkamah, yang berpuas hati bahawa adalah perlu bagi perlindungan dan keselamatan diri orang dilindungi itu, DENGAN INI MEMERINTAHKAN SELANJUTNYA YANG BERIKUT:

(a)

_______________________________________________________________________________________________

(b)

_______________________________________________________________________________________________

(c)

_______________________________________________________________________________________________

(d)

_______________________________________________________________________________________________

(e)

_______________________________________________________________________________________________

(f)

________________________________________________________________________________________________

Perintah perlindungan interim ini hendaklah terhenti berkuat kuasa—

P.U. (A) 3 10

DIBERI di bawah tandatangan saya dan meterai mahkamah di ___________________ pada

________________ hari bulan _________________________ tahun _________________

__________________________

(Hakim/Majistret)

Catatan:

Perintah ini hendaklah dilengkapkan dalam empat salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 11

BORANG 4

[Seksyen 5, 6 dan 11]

NEGERI _____________________________, MALAYSIA

DALAM MAHKAMAH ____________________________________________ DI _________________________________

NO. PERMOHONAN: _________________________________________________________________________________

NO. LAPORAN POLIS: ________________________________________________________________________________

BAHAWASANYA _____________________________________________________________________________

(nama orang dilindungi) *No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran:

____________________________________________________________________________________ yang beralamat di

_________________________________________________________________________________________________________

hadir di dalam mahkamah ini dan bahawasanya mahkamah, setelah membaca permohonan itu, berpuas hati bahawa beliau memerlukan suatu perintah perlindungan.

DENGAN INI DIPERINTAHKAN BAHAWA, ________________________________________________________

(nama orang yang terhadapnya perintah ini dibuat) *No. Kad Pengenalan/No. Pasport:

____________________________________________________________________________________ yang beralamat di

_________________________________________________________________________________________________________

dihalang daripada menggunakan keganasan rumah tangga terhadap orang dilindungi itu;

P.U. (A) 3 12

dilarang daripada menghasut mana-mana orang lain untuk melakukan keganasan rumah tangga terhadap orang dilindungi itu.

Mahkamah, yang berpuas hati atas imbangan kebarangkalian bahawa adalah perlu bagi perlindungan dan keselamatan diri orang dilindungi itu, DENGAN INI MEMERINTAHKAN

SELANJUTNYA YANG BERIKUT:

(a)

_______________________________________________________________________________________________

(b)

_______________________________________________________________________________________________

(c)

_______________________________________________________________________________________________

(d)

_______________________________________________________________________________________________

(e)

_______________________________________________________________________________________________

(f)

________________________________________________________________________________________________

Perintah ini hendaklah berkuat kuasa bagi suatu tempoh tidak melebihi dua belas bulan dari tarikh perintah ini dibuat.

DENGAN INI DIPERINTAHKAN SELANJUTNYA BAHAWA, _______________________________________

(nama orang yang terhadapnya perintah ini dibuat) hendaklah menghadiri program pemulihan yang disediakan oleh Kementerian yang bertanggungjawab bagi perkhidmatan kebajikan bagi maksud pembangunan keluarga dan masyarakat dan

______________________________________________ (nama orang dilindungi) boleh menghadiri program pemulihan itu.

P.U. (A) 3 13

DIBERI di bawah tandatangan saya dan meterai mahkamah di _________________________________

pada ____________________ hari bulan __________________________ tahun ________________________________

______________________________

(Hakim/Majistret)

Catatan:

Perintah ini hendaklah dilengkapkan dalam empat salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 14

BORANG 5

[Seksyen 3B]

ARAHAN UNTUK MENYAMPAIKAN PERINTAH PERLINDUNGAN KECEMASAN

Pegawai yang Bertanggungjawab bagi Daerah Polis ______________________________________________

Negeri _________________________________________________________________________________________________

Nama mangsa: ________________________________________________________________________________________

Jantina: _______________________________________________________________________________________________

*No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran:____________________________________________

No. Daftar Kes:________________________________________________________________________________________

DENGAN INI DIKEMUKAKAN sesalinan perintah perlindungan kecemasan yang dikeluarkan oleh Pegawai Kebajikan Masyarakat Diberi Kuasa bertarikh ______________________ berkenaan dengan _________________________________________________________________ (nama mangsa).

KAMU DENGAN INI DIARAHKAN untuk menyampaikan sesalinan perintah perlindungan kecemasan itu kepada _____________________________________________________________________________

(nama orang yang terhadapnya perintah itu dibuat).

Bertarikh ______________________________________

_________________________________________________

(Pegawai Kebajikan Masyarakat Diberi Kuasa)

Catatan:

Arahan ini hendaklah dilengkapkan dalam tiga salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 15

BORANG 6

[Seksyen 17]

PERINTAH UNTUK MENYAMPAIKAN PERINTAH PERLINDUNGAN INTERIM ATAU

Pegawai yang Bertanggungjawab bagi Daerah Polis ______________________________________________

Negeri _________________________________________________________________________________________________

Nama orang dilindungi: _____________________________________________________________________________

Jantina: _______________________________________________________________________________________________

*No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran: ____________________________________________

No. Laporan Polis: ____________________________________________________________________________________

DENGAN INI DIKEMUKAKAN sesalinan *perintah perlindungan interim/perintah perlindungan yang dikeluarkan oleh mahkamah bertarikh _______________________ berkenaan dengan

___________________________________________________________________________________________

(nama orang dilindungi).

KAMU DENGAN INI DIPERINTAHKAN untuk menyampaikan sesalinan *perintah perlindungan interim/perintah perlindungan itu kepada ________________________________________

(nama orang yang terhadapnya perintah itu dibuat).

Bertarikh ______________________________________

_________________________________

(Hakim/Majistret)

Catatan:

Perintah ini hendaklah dilengkapkan dalam tiga salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 16

BORANG 7

[Seksyen 3B dan 17]

PENYAMPAIAN PERINTAH PERLINDUNGAN KECEMASAN, PERINTAH PERLINDUNGAN

INTERIM ATAU PERINTAH PERLINDUNGAN

Kepada:

Nama: ________________________________________________________________________________________________

(nama orang yang terhadapnya perintah itu dibuat)

Kad

Pengenalan/

No. Pasport: __________________________________________________________________________________________

Alamat: _______________________________________________________________________________________________

_________________________________________________________________________________________________________

KAMU DENGAN INI DISAMPAIKAN sesalinan *perintah perlindungan kecemasan/perintah perlindungan interim/perintah perlindungan yang dikeluarkan oleh *mahkamah/Pegawai

Kebajikan Masyarakat Diberi Kuasa bertarikh _____________________________ terhadap kamu berkenaan dengan *mangsa/orang dilindungi.

Bertarikh ______________________________________

Cop Rasmi

______________________________________________________

(Pegawai yang Bertanggungjawab bagi Daerah Polis)

P.U. (A) 3 17

Akuan Penerimaan Penyampaian:

Saya, __________________________________________________________________________________________________

(nama orang yang terhadapnya perintah itu dibuat) *No. Kad Pengenalan/No. Pasport:

________________________________, dengan ini mengakui penerimaan sesalinan *perintah perlindungan kecemasan/perintah perlindungan interim/perintah perlindungan yang disampaikan kepada saya pada _____________________________________________________________________

______________________________

(Tandatangan)

Catatan:

Borang ini hendaklah dilengkapkan dalam tiga salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 18

BORANG 8

[Seksyen 3D]

BUKTI PENYAMPAIAN PERINTAH PERLINDUNGAN KECEMASAN

Kepada:

Pegawai Kebajikan Masyarakat Diberi Kuasa,

Pejabat Kebajikan Masyarakat ___________________________________________________________________

Dalam Daerah ______________________________________________________________________________________

Negeri _______________________________________________________________________________________________

DENGAN INI DIAKUI bahawa sesalinan perintah perlindungan kecemasan yang dikeluarkan oleh Pegawai Kebajikan Masyarakat Diberi Kuasa bertarikh _________________________

berkenaan dengan

________________________________________

(nama mangsa)

Kad

Pengenalan/No. Pasport/No. Sijil Kelahiran: _________________________ No. Daftar Kes:

________________________________________________________________________________ telah diterima oleh

________________________________________________ (nama Pegawai yang Bertanggungjawab bagi

Daerah Polis) pada _____________________________ dan sesalinan perintah itu telah disampaikan kepada ________________________________________________________________________________________________

(nama orang yang terhadapnya perintah itu dibuat) pada ________________________________________

P.U. (A) 3 19

Bertarikh _____________________________________

Cop Rasmi

______________________________________________________

(Pegawai yang Bertanggungjawab bagi Daerah Polis)

Negeri _____________________

Catatan:

Borang ini hendaklah dilengkapkan dalam dua salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 20

BORANG 9

[Seksyen 17]

BUKTI PENYAMPAIAN PERINTAH PERLINDUNGAN INTERIM ATAU

Kepada:

Pendaftar/Majistret,

DALAM MAHKAMAH ____________________________________________ DI ________________________________

DENGAN INI DIAKUI bahawa sesalinan *perintah perlindungan interim/perintah perlindungan yang dikeluarkan oleh mahkamah ______________________________________________ di

__________________________________________________ bertarikh ______________________________ berkenaan dengan __________________________________ (nama orang dilindungi) *No. Kad Pengenalan/

No. Pasport/No. Sijil Kelahiran: _____________________________________________ No. Laporan Polis:

__________________________________________________________________________________ telah diterima oleh

________________________________________________ (nama Pegawai yang Bertanggungjawab bagi

Daerah Polis) pada ______________________________ dan sesalinan perintah itu telah disampaikan kepada _______________________________________________________________________________________________

(nama orang yang terhadapnya perintah itu dibuat) pada ________________________________________

P.U. (A) 3 21

Bertarikh ______________________________________

Cop Rasmi

________________________________________________________

(Pegawai yang Bertanggungjawab bagi Daerah Polis)

Negeri _____________________

Catatan:

Borang ini hendaklah dilengkapkan dalam dua salinan.

*Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 22

BORANG 10

[Seksyen 3C]

PENYAMPAIAN GANTI PERINTAH PERLINDUNGAN KECEMASAN

Pegawai yang Bertanggungjawab bagi Daerah Polis ______________________________________________

Negeri _________________________________________________________________________________________________

Nama mangsa: ________________________________________________________________________________________

Jantina: _______________________________________________________________________________________________

*No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran: ____________________________________________

No. Daftar Kes: _______________________________________________________________________________________

KAMU DENGAN INI DIPERINTAHKAN untuk menyampaikan sesalinan perintah perlindungan kecemasan yang dikeluarkan oleh Pegawai Kebajikan Masyarakat Diberi

Kuasa bertarikh _______________________________________________________________ berkenaan dengan

______________________________________________________________________________________ (nama mangsa)

*No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran: _________________________ kepada

_________________________________________________________________________________________________________

(nama orang yang terhadapnya perintah itu dibuat)

dengan meninggalkan sesalinan perintah itu di alamat yang terakhir diketahui bagi orang yang terhadapnya perintah itu dibuat;

dengan apa-apa cara lain:_____________________________________________________________________

(sila nyatakan)

P.U. (A) 3 23

Bertarikh ______________________________________

________________________________________________

(Pegawai Kebajikan Masyarakat Diberi Kuasa)

Catatan: *Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 24

BORANG 11

[Seksyen 17A]

PENYAMPAIAN GANTI PERINTAH PERLINDUNGAN INTERIM

ATAU PERINTAH PERLINDUNGAN

Pegawai yang Bertanggungjawab bagi Daerah Polis ______________________________________________

Negeri _________________________________________________________________________________________________

Nama orang dilindungi: _______________________________________________________________________

Jantina: _______________________________________________________________________________________________

*No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran: ____________________________________________

No. Laporan Polis: ____________________________________________________________________________________

KAMU DENGAN INI DIPERINTAHKAN untuk menyampaikan sesalinan *perintah perlindungan interim/perintah perlindungan yang dikeluarkan oleh mahkamah

__________________________________________ di ________________________________ bertarikh ________________

berkenaan dengan

______________________________________________________________________________

(nama orang dilindungi) *No. Kad Pengenalan/No. Pasport/No. Sijil Kelahiran:

__________________________________ kepada _____________________________________________________________

(nama orang yang terhadapnya perintah itu dibuat)

dengan meninggalkan sesalinan perintah itu di alamat yang terakhir diketahui bagi orang yang terhadapnya perintah itu dibuat;

dengan menampalkan sesalinan perintah itu di papan notis mahkamah;

dengan apa-apa cara lain:______________________________________________________________________

(sila nyatakan)

P.U. (A) 3 25

Bertarikh _____________________________________

____________________________________________

(Hakim/Majistret)

Catatan: *Potong mana-mana yang tidak berkenaan.

P.U. (A) 3 26

Dibuat 7 Januari 2018

[KPWKM.PUU.(R).600-1/1/10.JLD2.(13); PN(PU2)545/II]

DATO’ SRI ROHANI BINTI ABDUL KARIM

Menteri Pembangunan Wanita, Keluarga dan Masyarakat

P.U. (A) 3 27

IN exercise of the powers conferred by paragraph 20(2)(b)

of the

Domestic Violence Act 1994 [Act 521], the Minister makes the following regulations:

Citation and commencement

Regulations 2018.

(2)

These Regulations come into operation on 10 January 2018.

Forms 2.

The Forms to be used for the purposes of the Act shall be as specified in the Schedule.

Transitional 3.

Anything arising from an application for an interim protection order or a protection order which is still pending before the court on the date of coming into operation of these

Regulations shall be dealt with by applying the forms under these Regulations.

Revocation 4.

The Domestic Violence (Prescribed Forms) Regulations 1999 [P.U. (A) 60/1999]

are revoked.

P.U. (A) 3 28

Jadual

[Regulation 2]

FORM 1

[Section 3A]

APPLICATION FOR EMERGENCY PROTECTION ORDER

For office purposes:

IN THE DISTRICT/STATE OF _____________________________________________________________________

CASE REGISTER NO.: ________________________________________________ YEAR: _____________________

WHEREAS I _________________________________________________________________________________

(name of the applicant) *Identity Card No./Passport No.: _______________________________ hereby make an application for an emergency protection order in respect of

________________________________________________________________________

(name of the victim)

*Identity

Card

No./Passport

No./Birth

Certificate

No.:

_____________________________

against ________________________________________________________________________________________________

(name of the person against whom the order is sought) Identity Card No./Passport No.:

_________________________________________________________________________________________________________

Note:

An application for an emergency protection order shall be made by—

(a)

the victim;

(b)

the victim’s counsel; or

(c)

in the case where the victim is a child or an incapacitated adult, the guardian, relative or person responsible for the care of such child or incapacitated adult or a social welfare officer other than an authorized social welfare officer.

*Delete whichever is not applicable.

P.U. (A) 3 29

Case Register No.: ____________________________________

Description of the domestic violence:

_________________________________________________________________________________________________________

Note: Please specify the relevant description of the domestic violence which shall include the act of the domestic violence, the relationship between the victim and the person against whom the order is sought, and the address where the domestic violence occurs or has occurred.

_______________________________

____________________________________________________

(Applicant) (Authorized Social Welfare Officer)

P.U. (A) 3 30

Case Register No.: ________________________________

For office purposes:

Decision of the Authorized Social Welfare Officer:

_________________________________________________________________________________________________________

Official Stamp

____________________________________________________

(Authorized Social Welfare Officer)

Date:

P.U. (A) 3 31

FORM 2

[Section 3A]

EMERGENCY PROTECTION ORDER

SOCIAL WELFARE OFFICE OF ______________________________________________________________________

IN THE DISTRICT OF ________________________________________________________________________________

STATE OF _____________________________________________________________________________________________

CASE REGISTER NO.: ______________________________________ YEAR: __________________________________

WHEREAS ____________________________________________________________________________________

(name of the victim)

*Identity

Card

No./Passport

No./Birth

Certificate

No.:

___________________________________________________________________________ having an address at

_________________________________________________________________________________________________________

is in need of an emergency protection order.

IT IS HEREBY ORDERED THAT, ________________________________________________________________

(name of the person against whom this order is made) *Identity Card No./Passport No.:

________________________________________________________________________

having an address at

_________________________________________________________________________________________________________

is prohibited from using domestic violence against the victim by wilfully or knowingly placing, or attempting to place, the victim in fear of physical injury;

P.U. (A) 3 32

is prohibited from using domestic violence against the victim by causing physical injury to the victim by such act which is known or ought to have been known would result in physical injury;

is prohibited from inciting any other person to commit domestic violence against the victim by wilfully or knowingly placing, or attempting to place, the victim in fear of physical injury;

is prohibited from inciting any other person to commit domestic violence against the victim by causing physical injury to the victim by such act which is known or ought to have been known would result in physical injury;

is prohibited from entering any protected person’s safe place, shelter, place of residence, shared residence or alternative residence.

This emergency protection order shall be valid for the period of seven days from the date of issuance of the order and enforceable when a copy of the order is served on

_________________________________________________________________________________________________________

(name of the person against whom this order is made)

Official Stamp

_____________________________________________

(Authorized Social Welfare Officer)

Date:

Note:

This order shall be completed in three copies.

*Delete whichever is not applicable.

P.U. (A) 3 33

FORM 3

[Section 4]

INTERIM PROTECTION ORDER

STATE OF _____________________________, MALAYSIA

IN THE ____________________________________________ COURT AT ______________________________________

APPLICATION NO.:__________________________________________________________________________________

POLICE REPORT NO.:________________________________________________________________________________

WHEREAS_____________________________________________________________________________________

(name of the protected person) *Identity Card No./Passport No./Birth Certificate No.:

_________________________________________________________________________ having an address at

_________________________________________________________________________________________________________

is present in this court and whereas the court, having read the application, is satisfied that he/she is in need of an interim protection order during the pendency of investigations relating to the commission of an offence involving domestic violence committed against him/her.

IT IS HEREBY ORDERED THAT, _____________________________________________________________________

(name of the person against whom this order is made) *Identity Card No./Passport No.:

____________________________________________________________________

having an address at

_________________________________________________________________________________________________________

P.U. (A) 3 34

is prohibited from using domestic violence against the protected person;

is prohibited from inciting any other person to commit domestic violence against the protected person.

The court, being satisfied that it is necessary for the protection and personal safety of the protected person, HEREBY FURTHER ORDERED THE FOLLOWING:

(a)

_______________________________________________________________________________________________

(b)

_______________________________________________________________________________________________

(c)

_______________________________________________________________________________________________

(d)

_______________________________________________________________________________________________

(e)

_______________________________________________________________________________________________

(f)

________________________________________________________________________________________________

This interim protection order shall cease to have effect—

(a)

upon the protected person being informed in writing by a police officer about the completion of the investigations and that there is no further action to be taken against the person against whom this order is made;

(b)

upon the institution of a criminal proceeding against the person against whom this order is made if, upon being informed in writing by a police officer that a criminal proceeding relating to the commission of an offence involving domestic violence will be instituted against the person against whom this order is made, no application for a protection order is made by the protected person within seven days after being so informed; or

(c)

upon the determination of an application for a protection order by the court if, upon being informed in writing by a police officer that a criminal proceeding relating to the commission of an offence involving domestic violence will be instituted against

P.U. (A) 3 35

the person against whom this order is made, the application for the protection order is made by the protected person within seven days after being so informed.

GIVEN under my hand and seal of the court at _____________________ on the ____________________

day of _______________ year ___________________

__________________________

(Judge/Magistrate)

Note:

This order shall be completed in four copies.

*Delete whichever is not applicable.

P.U. (A) 3 36

FORM 4

[Sections 5, 6 and 11]

PROTECTION ORDER

STATE OF _____________________________, MALAYSIA

IN THE ____________________________________________ COURT AT ______________________________________

APPLICATION NO.:___________________________________________________________________________________

POLICE REPORT NO.: ________________________________________________________________________________

WHEREAS ___________________________________________________________________________________

(name of the protected person) *Identity Card No./Passport No./Birth Certificate No.:

_______________________________________________________________________

having an address at

_________________________________________________________________________________________________________

is present in this court and whereas the court, having read the application, is satisfied that he/she is in need of a protection order.

IT IS HEREBY ORDERED THAT, _____________________________________________________________________

(name of the person against whom this order is made) *Identity Card No./Passport No.:

_________________________________________________________________________ having an address at

_________________________________________________________________________________________________________

is restrained from using domestic violence against the protected person;

P.U. (A) 3 37

is prohibited from inciting any other person to commit domestic violence against the protected person.

The court, being satisfied on a balance of probabilities that it is necessary for the protection and personal safety of the protected person, HEREBY FURTHER ORDERED THE

FOLLOWING:

(a)

_______________________________________________________________________________________________

(b)

_______________________________________________________________________________________________

(c)

_______________________________________________________________________________________________

(d)

_______________________________________________________________________________________________

(e)

_______________________________________________________________________________________________

(f)

________________________________________________________________________________________________

This protection order shall have effect for a period not exceeding twelve months from the date this order is made.

IT IS HEREBY FURTHER ORDERED THAT, ______________________________________________________

(name of the person against whom this order is made) shall attend the rehabilitation programme provided by the Ministry responsible for welfare services for the purposes of family and community development and ______________________________________________________

(name of the protected person) may attend the rehabilitation programme.

P.U. (A) 3 38

GIVEN under my hand and seal of the court at _____________________ on the __________________ day of _______________ year _______________________

______________________________

(Judge/Magistrate)

Note:

This order shall be completed in four copies.

*Delete whichever is not applicable.

P.U. (A) 3 39

FORM 5

[Section 3B]

DIRECTION TO SERVE EMERGENCY PROTECTION ORDER

Officer in Charge of the Police District _____________________________________________________________

State of ________________________________________________________________________________________________

Name of victim: _______________________________________________________________________________________

Gender: _______________________________________________________________________________________________

*Identity Card No./Passport No./Birth Certificate No.:___________________________________________

Case Register No.:____________________________________________________________________________________

IT IS HEREBY FOWARDED a copy of the emergency protection order which is issued by the

Authorized

Social

Welfare

Officer dated

_______________________

in respect of

_________________________________________________________________________________ (name of the victim).

YOU ARE HEREBY DIRECTED to serve a copy of the emergency protection order on

_________________________________________________________________________________________________________

(name of the person against whom the order is made).

Dated ______________________________________

____________________________________________

(Authorized Social Welfare Officer)

Note:

This direction shall be completed in three copies.

*Delete whichever is not applicable.

P.U. (A) 3 40

FORM 6

[Section 17]

ORDER TO SERVE INTERIM PROTECTION ORDER OR PROTECTION ORDER

Officer in Charge of the Police District _____________________________________________________________

State of _______________________________________________________________________________________________

Name of protected person: _________________________________________________________________________

Gender: _______________________________________________________________________________________________

*Identity Card No./Passport No./Birth Certificate No.:____________________________________________

Police Report No.:____________________________________________________________________________________

IT IS HEREBY FOWARDED a copy of the *interim protection order/protection order which is issued by the court dated ______________________________________ in respect of

________________________________________________________________________________________________________

(name of the protected person).

YOU ARE HEREBY ORDERED to serve a copy of the *interim protection order/protection order on

_______________________________________________________________________________________

(name of the person against whom the order is made).

Dated ______________________________________

_________________________________

(Judge/Magistrate)

Note:

This order shall be completed in three copies.

*Delete whichever is not applicable.

P.U. (A) 3 41

FORM 7

[Sections 3B and 17]

SERVICE OF EMERGENCY PROTECTION ORDER, INTERIM PROTECTION ORDER

OR PROTECTION ORDER

Name: _________________________________________________________________________________________________

(name of the person against whom the order is made) *Identity Card No./Passport No.:

_________________________________________________________________________________________________________

Address: ______________________________________________________________________________________________

_________________________________________________________________________________________________________

YOU ARE HEREBY SERVED WITH a copy of the *emergency protection order/interim protection order/protection order which is issued by the *court/Authorized Social Welfare

Officer dated _____________________________ against you in respect of the *victim/protected person.

Dated ______________________________________

Official Stamp

______________________________________

(Officer in Charge of the Police District)

P.U. (A) 3 42

Acknowledgement of Receipt of Service:

I, _______________________________________________________________________________________________________

(name of the person against whom the order is made) *Identity Card No./Passport No.:

________________________________, hereby acknowledge receipt a copy of the *emergency protection order/interim protection order/protection order served on me on

___________________________________________

______________________________

(Signature)

Note:

This form shall be completed in three copies.

*Delete whichever is not applicable.

P.U. (A) 3 43

FORM 8

[Section 3D]

PROOF OF SERVICE OF EMERGENCY PROTECTION ORDER

Authorized Social Welfare Officer,

Social Welfare Office of _____________________________________________________________________________

In the District of ____________________________________________________________________________________

State of _______________________________________________________________________________________________

IT IS HEREBY ACKNOWLEDGED that a copy of the emergency protection order which is issued by the Authorized Social Welfare Officer dated _________________________ in respect of

____________________________________________________________________________ (name of the victim)

*Identity Card No./Passport No./Birth Certificate No.: _______________________________

Case Register No.: ______________________________________________________ had been received by

________________________________________________ (name of the Officer in Charge of the Police District)

on _____________________________ and a copy of the order had been served on

_________________________________________________________________________________________________________

(name of the person against whom the order is made) on __________________________________________

P.U. (A) 3 44

Dated ______________________________________

Official Stamp

______________________________________

(Officer in Charge of the Police District)

State of ____________________

Note:

This form shall be completed in two copies.

*Delete whichever is not applicable.

P.U. (A) 3 45

FORM 9

[Section 17]

PROOF OF SERVICE OF INTERIM PROTECTION ORDER OR PROTECTION ORDER

Registrar/Magistrate,

IN THE ____________________________________________ COURT AT ______________________________________

IT IS HEREBY ACKNOWLEDGED that a copy of the *interim protection order/protection order which is issued by the __________________________ court at ___________________________________

dated ________________________ in respect of _______________________________________________________

(name of the protected person) *Identity Card No./Passport No./Birth Certificate No.:

_________________________________________________________________________________________________________

Police Report No.: ______________________________________________________ had been received by

________________________________________________ (name of the Officer in Charge of the Police District)

on ______________________________ and a copy of the order had been served on

_________________________________________________________________________________________________________

(name of the person against whom the order is made) on __________________________________________

P.U. (A) 3 46

Dated ______________________________________

Official Stamp

______________________________________

(Officer in Charge of the Police District)

State of _____________________

Note:

This form shall be completed in two copies.

*Delete whichever is not applicable.

P.U. (A) 3 47

FORM 10

[Section 3C]

SUBSTITUTED SERVICE OF EMERGENCY PROTECTION ORDER

Officer in Charge of the Police District ______________________________________________________________

State of ________________________________________________________________________________________________

Name of victim: _______________________________________________________________________________________

Gender: _______________________________________________________________________________________________

*Identity Card No./Passport No./Birth Certificate No.:___________________________________________

Case Register No.:____________________________________________________________________________________

YOU ARE HEREBY ORDERED to serve a copy of the emergency protection order issued by the Authorized Social Welfare Officer dated _________________________ in respect of

_____________________________________________________________________________ (name of the victim)

*Identity Card No./Passport No./Birth Certificate No.: _____________________________________ on

_________________________________________________________________________________________________________

(name of the person against whom the order is made)

by leaving a copy of the order at the last known address of the person against whom the order is made;

by any other manner:__________________________________________________________________________

(please specify)

P.U. (A) 3 48

Dated ______________________________________

________________________________________________

(Authorized Social Welfare Officer)

Note: *Delete whichever is not applicable.

P.U. (A) 3 49

FORM 11

[Section 17A]

SUBSTITUTED SERVICE OF INTERIM PROTECTION ORDER OR PROTECTION ORDER

Officer in Charge of the Police District ______________________________________________________________

State of ________________________________________________________________________________________________

Name of protected person: __________________________________________________________________________

Gender: _______________________________________________________________________________________________

*Identity Card No./Passport No./Birth Certificate No.:___________________________________________

Police Report No.:____________________________________________________________________________________

YOU ARE HEREBY ORDERED to serve a copy of the *interim protection order/protection order which is issued by the __________________________ court at ___________________________________

dated ________________________ in respect of _______________________________________________________

(name of the protected person) *Identity Card No./Passport No./Birth Certificate No.:

_________________________________________________________________________________________________________

on ____________________________________________________________________________________________________

(name of the person against whom the order is made)

by leaving a copy of the order at the last known address of the person against whom the order is made;

by posting a copy of the order on the court’s notice board;

by any other manner:__________________________________________________________________________

(please specify)

P.U. (A) 3 50

Dated _____________________________________

____________________________________________

(Judge/Magistrate)

Note: *Delete whichever is not applicable.

P.U. (A) 3 51

Made 7 January 2018

[KPWKM.PUU.(R).600-1/1/10.JLD2.(13); PN(PU2)545/II]

DATO’ SRI ROHANI BINTI ABDUL KARIM

Minister of Women, Family and Community Development

Common questions

What is PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018?: PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 is Malaysia P.U. (A), cited as P.U. (A) 3 2018, currently marked in force and first recorded in 2018.
Is PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 still in force?: Yes — PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 is currently in force.
When did PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 take effect?: PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 was first recorded in 2018.
How many sections does PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 have?: PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 contains 4 sections.
Where can I read the official version of PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018?: The official text of PERATURAN-PERATURAN KEGANASAN RUMAH TANGGA (BORANG YANG DITETAPKAN) 2018 is published at lom.agc.gov.my.