We, 1. ________ (Maiden name of wife)
2. ________ (Name of husband)
Solemnly declare and affirm as under:
1. That we are married under________Marriage Act/Rights/Customs and are living together as married couple since________ (Date of marriage)
2. That ________ would henceforth be known as_______ by virtue of our marriage.
3. That our joint photograph is affixed below.
Signature & Address of Deponents