53 Pa. Stat. § 53506
For the purpose of having such question appear upon the ballot the council shall certify the question to the county board of elections at least twenty-one days before the day of election. The question may be stated substantially as follows:
"Shall the town of ____________________ acquire by purchase, or condemnation, or both, at a price not exceeding __________ dollars (or by lease for not more than __________ years at an annual rental of not more than __________ dollars) property for the purpose of making (or of enlarging) public parks, parkways and playgrounds and playfields, including swimming pools, bathing places, indoor recreation centers and gymnasiums within the locality bounded by ____________________ ."
The council may at their discretion omit the designation of the locality.
53 P.S. § 53506