CERTIFICATION OF COMPLETION OF
PREMARITAL PREPARATION COURSE

I certify that	,	bride and	,	groom have
successfully completed a premarital preparation course, pursuant to S.C. Code § 20-1-230(B), and are
entitled to a one-time fifty dollar non-refundable South Carolina state income tax credit as permitted in
S.C. Code § 12-6-3381.
I further certify that I am a professional counselor who is licensed pursuant to Chapter 75 of Title 40; OR
am an active member of the clergy and provided counseling in the course of my service as clergy; OR such
services were provided by a clergy’s designee, including retired clergy, and that the designee is trained
and skilled in premarital preparation.
I further certify that the participants completed the course together, rather than separately.
I further certify that the course was completed by the couple on	.
I further certify that a minimum of six (6) hours was completed.

Counselor (print)
Counselor (signature)

Counselor’s Credentials
Course Completion Date

Hours Completed

SCCA #153PC (12/06)

20-1-230(B), 12-6-3381

CERTIFICATION OF COMPLETION OF

imgrunda

2007-02-06

SCJD

RICHLAND COUNTY