52 Pa. Code § 1001.56
(a) The form of certificate of service must be as follows:
I hereby certify that I have this day served a true copy of the foregoing document upon the parties, listed below, in accordance with the requirements of § 1001.52 (relating to service by a party).
(List names and addresses of parties served and manner in which each was served.)
Dated this
day of 2 .
(Print Name)
Counsel for
This section cited in 52 Pa. Code § 1001.10 (relating to definitions); and 52 Pa. Code § 1001.55 (relating to proof of service).