2010 Pennsylvania Code
Title 23 - DOMESTIC RELATIONS
Chapter 15 - Marriage Ceremony
1502 - Forms where parties perform ceremony.

     § 1502.  Forms where parties perform ceremony.
        (a)  Declaration of authorization.--In all cases in which the
     parties intend to solemnize their marriage by religious ceremony
     without officiating clergy, the marriage shall not take place
     until their right so to do is certified in a declaration in
     substantially the following form:
        Commonwealth of Pennsylvania
                                      ss:                   No. ....
        County of (name)
        To (name) and (name)
            Legal evidence having been furnished to me, in accordance
        with law, this certifies that I am satisfied that there is no
        legal impediment to you joining yourselves together in
        marriage.
                                    Signed ..........................
                                                (Official Title)
        (b)  Marriage certificates.--In lieu of the certificate set
     forth in section 1501 (relating to form of marriage
     certificates), there shall be appended to the declaration two
     certificates, numbered to correspond to the declaration, in the
     following form:
            We hereby certify that on (date), we united ourselves in
        marriage, at (city, borough or town), County of (name),
        Pennsylvania, having first obtained from the Court of Common
        Pleas of (name) a declaration numbered .... that the court
        was satisfied that there was no existing legal impediment to
        our so doing.
                                    Signed ..........................
                                    Signed ..........................
            We, the undersigned, were present at the solemnization of
        the marriage of (name) and (name), as set forth in the
        foregoing certificate.
                                    Signed ..........................
                                    Signed ..........................