4 Pa. Code § 171.12
(a) A person qualified to vote for President and Vice President under the provisions of the 1970 Voting Rights Act Amendments (42 U.S.C.A. § 1973aa et seq.) as described in the opinion of the Attorney General which appears at 2 Pa.B. 1913, shall be allowed to register absentee for the purposes of voting for the President and Vice President if they submit the following affidavit:
I hereby swear (or affirm) that I am unable to register in person by reason of absence from my election district, that on the day of the next ensuing election I shall have been a citizen of the United States for at least one month, that I will be 18 years of age, on the day after the election, that I will have been a resident of the Commonwealth and my election district for at least thirty (30) days, that I will be legally qualified to vote, and that I have read (or have had read to me) the foregoing statements made in connection with my registration and that they are true and correct.