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ቀን -----------------------------

ለ ---------------------------------------- ፍ/ቤት

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የአቤቱታው ርዕስ፡- በፍ/ብ/ሥ/ሥ/ሕ/ቁ 35ዐ መሠረት የግልግል ወይም የቤተ ዘመድ

ሽምግልና ዳኞች በሰጡት ውሣኔ ላይ የቀረበ ይግባኝ

ይግባኝ ባይ/ባዮች 1. ----------------------------------------- አድራሻ ------------------------------

2. ----------------------------------------- አድራሻ ------------------------------

3. ----------------------------------------- አድራሻ ------------------------------

መልስ ሰጭ/ዎች 1. ----------------------------------------- አድራሻ ------------------------------

2. ----------------------------------------- አድራሻ ------------------------------

3. ----------------------------------------- አድራሻ ------------------------------

ሀ. ይግባኝ የተባሉበትን ውሣኔ የሰጡት የ ------------------------------- ዳኞች ናቸው

ለ. ይግባኝ የተባለበት ውሣኔ የተሰጠው በ ----------------- ቀን -------------- ዓ.ም ነው

የይግባኝ ቅሬታው ዝርዝር መግለጫ

የክርክሩ አመጣጥ የቤተዘመድ 2. ሽምግልና ወይም የግልግል ዳኞች በሰጡት ውሣኔ -----------
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------------------------------------------------------------------ ነው፡፡

ለይግባኝ ቅሬታ የሆኑ ምክንያቶች

ሀ. የቤተዘመድ ሽምግልና ወይም የግልግል ዳኞች የሰጡት ውሣኔ በ -------------------------------

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-------------------------------------------- ምክንያት የተሣሣተ ነው ፡፡

ለ. የግልግል ወይም የሽምግልና ጉባዔ አባላት እንዲወሰኑ የቀረበላቸው ጉዳይ --------------------

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---------------------------------------- ሆኖ ሣለ ሣይወሰን ቀርቷል፡፡

ሐ. የግልግል ወይም የሽምግልና ጉባዔ ክርክሩን የሰሙት በ ------------------------------------------

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---------------------------- ምክንያት ከሥነ-ሥርዓት ውጭ ነው ፡፡

መ. የግልግል ወይም የሽምግልና ጉባዔ ጉዳዩ የሚሰማበትን ቀንና ሥፍራ በ ---------------------

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----------------------------------------------------------------------------------- ለእኔ/እኛ መግለጽ
የሚገባቸው ቢሆንም አልገለጸልኝም/ንም/፡፡

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ሠ. ግራ ቀኙ ተከራካሪዎች እንዲታይልኝ/ን/ በስምምነት ያቀረበ ነው ማስረጃ በ -----------------
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---------------------------------------------------------------------- ምክንያት አልታየልንም

ረ. የግልገል ወይም የሽምግልና ዳኞች የሰጡት ውሣኔ በ ----------------------------------------------

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--------------- ምክንያት አድሎ ያለበት ነው፡፡

ሰ. ሌሎች ---------------------------------------------------------------------------------------------------------
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በመሆኑም ፍ/ቤቱ ከላይ የተዘረዘሩትን ቅሬታዎች በተገቢው ሁኔታ መርምሮ የግልግል ወይም
የሽምግልና ጉባዔ የሰጡትን ውሣኔ በፍ/ብ/ሥ/ሥ/ሕቁ 353 መሠረት እንዲሠረዝልኝ/ን/
አመለክታለሁ/እናመለክታለን/፡፡

አቤቱታ እውነት ለመሆኑም በፍ/ብ/ሥ/ሥ/ሕ/ቁ.92 መሠረት አረጋግጣለሁ፡፡

የይግባኝ ባይ/ዮች/ 1ኛ.--------------------------- ፊርማ------------------

2ኛ.--------------------------- ፊርማ------------------

3ኛ.--------------------------- ፊርማ------------------

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