Pennsylvania has no statewide domestic partnership form. To document a domestic partnership in Pennsylvania, you complete one of three forms depending on who will recognize the relationship: Philadelphia’s Life Partnership verification packet, Pittsburgh’s Declaration of Mutual Commitment, or an affidavit provided by your employer, university, or insurer. Each has its own eligibility rules, supporting-document requirements, and filing steps, and the right form is determined by where you live or work and what you need the partnership recognized for.
Which Form You Need
Start with the purpose. If you want an official municipal record of the partnership and you have a Philadelphia connection, use the Life Partnership packet. If your connection is to Pittsburgh, use the Mutual Commitment Registry form. If you only need to enroll a partner on workplace health insurance or other employee benefits, your employer’s benefits office will usually give you its own affidavit, and that form — not a municipal certificate — is what governs the enrollment.
A city certificate can sometimes double as one of the supporting documents an employer requires, but employers set their own rules about what counts. Ask the benefits office before assuming a Philadelphia or Pittsburgh registration alone will enroll your partner.
Philadelphia Life Partnership Form
Philadelphia’s program runs under Chapter 9-1100 of the Philadelphia Code and is administered by the Marriage License Department at City Hall.
Who Qualifies
Both partners must meet all of the following:
- Both are Philadelphia residents, or at least one is employed in the city, owns real property there, runs a business there, or has a vested interest in city employee benefits.
- Both are at least 18 and mentally competent to enter a contract.
- They are not related by blood in a way that would prohibit marriage under Pennsylvania law.
- Neither has another Life Partner.
- Neither has been in a different Life Partnership within the past twelve months, unless that earlier partnership ended because the other partner died.
- Both agree to share the common necessities of life, be responsible for each other’s welfare, and share at least one residence.
- Both agree, under penalty of law, to notify the city of any change in the partnership’s status.1City of Philadelphia. Register a Life Partnership
Supporting Documents
You must show that you and your partner have been financially interdependent for at least 90 days. Bring at least two documents from the following list, and each must reflect dates covering that 90-day window:
- Common ownership of real property or a shared lease
- Common ownership of a motor vehicle
- Driver’s licenses or state-issued IDs listing a shared address
- Joint bank accounts or credit accounts
- Designation of the other partner as a beneficiary for life insurance or retirement benefits
- Appointment of the other partner as agent under a durable power of attorney or health care power of attorney
- Common legal guardianship of an adopted, foster, or dependent child2American Legal Publishing. Philadelphia Code 9-1123 – Verification of Life Partnerships
How to Submit It
Download the Life Partnership registration packet from the city’s website and complete the verification statement checklist in blue or black ink.3City of Philadelphia. Life Partnership Packets and Resources Email the completed checklist and copies of your supporting documents to lifepartnership@phila.gov. If the initial review clears, the Marriage License Department will send instructions for scheduling an in-person appointment.
Both partners then appear at the Marriage License Department in City Hall, Room 415, Philadelphia, PA 19107. Bring government-issued photo IDs and the originals of every supporting document you submitted; photocopies are not accepted at the appointment. The filing fee is $40, paid at the appointment once your application is pre-approved.1City of Philadelphia. Register a Life Partnership
Pittsburgh Declaration of Mutual Commitment
Pittsburgh’s form is simpler. To be eligible, both partners must be at least 18 and unmarried under Pennsylvania law, competent to enter a contract, freely declaring that they are solely and mutually committed to each other, and either Pittsburgh residents or non-residents subject to the city’s wage tax.
The city’s prescribed form is called the Declaration of Mutual Commitment. It includes statements that the partners are in a relationship of mutual commitment, support, and caring, and that they are responsible for each other’s welfare. Fill in the mailing addresses of both partners and sign the declaration in front of a notary. Unlike Philadelphia, Pittsburgh does not require you to submit interdependency documents; the notarized declaration itself is the evidence.
The filing fee is $25, which covers two certified copies of the official statement. File the form with the Department of Human Resources and Civil Service, which maintains the registry.4eCode360. Domestic Partnership and Common Law Spouse Benefits
Employer Affidavit Forms
Many Pennsylvania employers, universities, and insurers use their own domestic partnership affidavits to establish that a partner qualifies for workplace benefits like health, dental, or life insurance. These forms are narrower than the municipal registries: they exist to enroll a dependent, not to create a citywide public record.
Employer forms typically require both partners to attest under oath that they share a residence, are in an exclusive committed relationship, are not married to anyone else, are at least 18 and not related by blood, and share financial obligations. Most also require supporting documentation, commonly three items such as a joint lease, a shared bank account, powers of attorney naming each other, or beneficiary designations. The form usually has to be notarized or signed in front of a benefits office representative.
Follow the instructions on your specific employer’s form. If it accepts a Philadelphia Life Partnership certificate or a Pittsburgh Mutual Commitment declaration in place of one of the required supporting documents, the form or the benefits office will say so.
Filling In the Form
The core fields look similar across all three types. A few spots cause most of the delays.
Legal names. Write your full legal name exactly as it appears on your government-issued ID. A mismatch can force you to redo the appointment. If you have legally changed your name, bring the court order or the amended ID.
Shared residential address. Both partners list the same primary residence, and the address should match at least one supporting document (a joint lease, a shared utility bill, or a state-issued ID showing a common address). A P.O. box does not count.
Sworn statements. Read every affirmation before signing: that you are not currently married, that you are each other’s sole partner, that you share financial responsibilities. In Philadelphia these statements are made under penalty of perjury.2American Legal Publishing. Philadelphia Code 9-1123 – Verification of Life Partnerships Signing a false affidavit can carry legal consequences beyond losing benefits.
Supporting documents. Assemble them before you start the form. Philadelphia needs at least two qualifying documents covering 90 days of interdependency. Pittsburgh requires none beyond the notarized declaration. Employer forms specify their own count and categories.
Notarization
Pittsburgh’s Declaration of Mutual Commitment must be notarized, and employer affidavits almost always require it as well. Philadelphia’s Life Partnership is finalized at an in-person appointment rather than through a traditional notary, but the verification statement is still signed under penalty of perjury.
Pennsylvania caps notary fees at $5 per acknowledgment for the first signer and $2 for each additional name.5Commonwealth of Pennsylvania. Notary Public Fees For a two-signer domestic partnership affidavit, the notarial act itself should cost no more than $7. Notaries at banks, UPS stores, or law offices may add a separate service fee, so ask about the total before signing.
What You Receive After Filing
Philadelphia issues a Life Partnership certificate once registration is complete. This is your primary proof of the partnership for benefits enrollment, hospital situations, or anywhere else you need to establish the relationship.
Pittsburgh gives you two certified copies of your Declaration of Mutual Commitment at the time of filing, included in the $25 fee. Additional certified copies can be requested from the Department of Human Resources and Civil Service.
For an employer affidavit, the benefits office processes the form and enrolls your partner within the plan’s standard enrollment window, often within 30 days. Keep a personal copy of the signed, notarized affidavit and copies of every document you submitted.
Keeping the Record Accurate
A domestic partnership form is not a one-and-done filing. Update your address with the city registry or benefits office if you move. In Philadelphia, if the city-connection requirement stops being met, the partnership’s recognition can lapse. A Philadelphia Life Partnership terminates automatically if either partner dies or enters into a marriage recognized in Pennsylvania.
If you want to end the partnership by choice, use the same office that recorded it. In Philadelphia, either partner may file a sworn Termination Statement; when both sign, the termination takes effect 60 days after filing, and when only one signs, it takes effect 60 days after proof is filed that the other partner was served with a copy, either personally or by certified or registered mail.6American Legal Publishing. Philadelphia Code 9-1124 – Termination of Life Partnerships In Pittsburgh, either partner files a termination notice with the Department of Human Resources and Civil Service, at no charge.4eCode360. Domestic Partnership and Common Law Spouse Benefits For an employer affidavit, notify the benefits department in writing; most employers require notice within 30 days, and late notice can result in benefits being retroactively revoked and claims clawed back.
Store the certificate or notarized affidavit with your other critical documents. You will need it quickly the first time you enroll in benefits, visit a partner in the hospital, or otherwise have to prove the relationship on short notice.