Indiana Code § 31-11-4-15

Marriage certificates
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Sec. 15. Each marriage license must have two (2) certificates attached to the license. The Indiana department of health shall prescribe a uniform form for these certificates. One (1) certificate must be marked "Original" and one (1) certificate must be marked "Duplicate". Each certificate must contain the following: MARRIAGE CERTIFICATE I ________ (name) certify that on ______ (date) at ______ in _______ County, Indiana, _______ of ______ County, ______ (state) and _______ of ______ County, _____ (state) were married by me as authorized under a marriage license that was issued by the Clerk of the Circuit Court of _______ County, Indiana, dated _______. Signed (OFFICIAL DESIGNATION) [Pre-1997 Recodification Citation: 31-7-3-14.]

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