The ______ day to Shabbos ______ days to the month of _________ five thousand seven hundred and ____ years since creation as we count here in (country), behold Mr. ________ son of __________ said to this young woman _______ daughter of _______ 'be unto me a wife in accord with the law of Moses and the Jews, and I will serve, cherish, feed and provide for you on your standard in the manner of Jewish men that serve, cherish, feed and provide for their wives with integrity. I give to you the dowry of your youth two hundred silver pieces that you are entitled under biblical law, and your food, clothing, needs and company like the way of all man'. This young woman _______ has desired and become to him as a wife. For the dowry that she brought unto him from her father's house, whether silver, or gold, or jewellery, or garments, or linens for all of this ______ has undertaken for one hundred silver pieces, and ___ has desired and added from his own account a corresponding one hundred silver pieces equalling two hundred silver pieces, and _____ has said 'the responsibility of the Ketubah deed, dowry, and extra, I accept upon myself and my inheritors that come after me, to pay from all finest cloths, properties or chattels that I possess beneath the heavens, whether I posses them now or that I will acquire, real property or possessions, shall all be available to underwrite and guarantee to pay from them this Ketubah deed, dowry, and extra from me or even from the shirt on my back, during my lifetime or thereafter'. The responsibility for and context of this Ketubah deed, dowry and extra has been undertaken by our groom _______ with the sincerity of all ketubah deeds and dowries that are customary for Jewish women, as enacted in accord with the directive of our Sages of blessed memory, not as a bragging jest nor as a mere script. We received undertaking from our groom ________ son of ________ unto this young woman Mrs. _________ daughter of __________ for everything that is written and expressed above by means of an item that is suitable for acquisitions, and all is correct and confirmed.

Declared by _______________________ witness

Declared by _______________________ witness