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DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Mohammed Ferhuth Sharif
MIDDLE CURRENT SURNAME
1ST 0 0 1ST 0 0
2ND 0 0 2ND 0 0
3RD 0 0 3RD 0 0
4TH 0 0 4TH 0 0
I duly swear/affirm. depose and say, t nowledge and belief that the information I provided is t.h. a..?:o I gal impediment exists
as to my right to enter into the mar
21. SIGNATURE OF GROOM~
23. SUBSCRIBED AND SWORN TOIA FIRME NAME 07/07/2009
SIGNATURE OF TOWN OR CITY CLERK DATE
This license authorizes the marriage in New York Stilte 01 the bride and. groom .named above' by . any ,person authorized. by New' York Domestic
Relations Law ~11 to perform marriage ceremonies within New York State. THIS LICENSE VALID IN NEW YORK STATE ONLY,
o If checked. this license is to be used only for the purpose of a second or subsequent ceremony.
~ 24, TOWN OR CITY q.ERKC M 25. A. SOLEMNIZATION PERIOD BEGINS
} NAME (PRINT) JOnn . asterson . .
{SEAL SIGNATURE ~ DATE 07/07/2009 TIME MONTH
"-v-I MA~tfMRrme sh Rd, Wappingers Falls, NY 12590 03:23;~ 07 08 2009 09 05 2009
STREET CITYITOWN STATE ZIP
~~~R~:RT~~~ IO~O~~~N~ZEE~ 26 SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
SONS NAMED ABOVE ON THE TIME MO. DAY YEAR 0 ft}-RELlGIOUS
DATE AND AT THE TIME AND /1 AM ~C: . /1;..,... ee,
PLACE INDICATED. PM c..' OJ 9 0 OTHER, SPECIFY
~~~n~<;;~ f'.1\.l\\o\-Ai'-"I('.""Ao AS,'L '\<'r\Af'l TITLE lfV\Al\.'\
SIGNATURE~ ~~\,;t~ DATE oS, (5. ~'7
MAILING ADDRESS
1'2.. S ,:q L L At.; tit: L<; ;-// l-L (.(:D v..) APP /')"; 4E.tfLS.
STREET CITYITOWN STATE
30. WITNESS TO CEREMONY
NAME (PRINT) ,kA,
/"
COUNTY Dutchess
CITYITOWN Wappinger
~~~:~c: 1368
~5~I:J~R 67
1. A. FULL NAME
FIRST
D..
N
B. BIRTH NAME. IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE) 1 08-58-5526
D. SOCIAL SECURITY NUMBER
2. RESIDENCE A. NY B. Dutchess
(STATE) J. (COUNTY)
C. CHECK ONE 0 CITY U TOWN 0 VILLAGE
~~~CIFY Wappinger
o STREET ADORESS 11 Sherrywood Rd. ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES,] NO
10 /02 /1975
DAY YEAR
3. A. AGE 33
3B. DATE OF BIRTH
MONTH
....
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<(
c
wi!
elL&.
-<(
4. EMPLOYMENT
A USUAL OCCUPATION Banker
B. TYPE OF INDUSTRY OR BUSINESS Accounting
5. PLACE OF BIRTH Middletown, Ny
(CITY. STATE I COUNTRY IF NOT USA)
6. FATHER
A. NAME Azmat U, Sharif
B. COUNTRY OF BIRTH India
7. MOTHER
A. MAIDEN NAME Rizwana B. Begum
B. COUNTRY OF BIRTH India
1
8. NUMBIiR OF THIS MARRIAGE
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
DEATH
o
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
(2) 0 DEATH
MONTH DAY YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
10. IF PREVIOUSLY DIVORCED OR ANNULLED. PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY/COUNTY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
SIGNATURE~
DOH-98 (0312006)
(THIS SPACE FOR STATE USE ONL Y)
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Labeebah Zakiyyah Oglesby
MIDDLE CURRENT SURNAME
-1
11. A. FULL NAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Sharif
(OPTIONAL. SEE REVERSE)145-72-0387
D. SOCIAL SECURITY NUMBER
12 RESIDENCE ANJ B. Essex
(STA~ (COUNTY)
C. CHECK ONE CITY 0 TOWN 0 VILLAGE
~~~CIFY Newar
D. STREET ADDRESS::3bB :schley :st.
U/11L
ZIP
.t.
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATEO VILLAGE? 0
13. A. AGE 29 3B. DATE OF BIRTH 05 ,.28
MONTH DAY
YES 0 NO
)'980
YEAR
14. EMPLOYMENT
A. USUAL OCCUPATION Banker
B. TYPE OF INDUSTRY OR IilUSI!'If;SS. Accountll"!9
15. PLACE OF BIRTH NewarK, . NJ
(CITY. STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Gregory Webb
'B. COUNTRY OF BIRTHU S A
17. MOTHER
A. MAIDEN NAME Vickie Ogl~?by
B. COUNTRY OF BIRTHU S. A
1
18. NUMBER OF THIS MARRIAGE
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVlOUS MARRIAGES WHICH ENDED BY
DIOORCE CIVIL A~ULMENT
D11TH
B. HOW DID LAST MARRIAGE END?
(3) 0 DIVORCE
(3) 0 ANNULMENT (2) 0 DEATH
/ /
~ - YEAR
C. DATE LAST MARRIAGE ENDED?
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
~
20. IF PREVIOUSLY DIVORCED OR ANNULLED. PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH. DAY, YEAR) (CITY/COUNTY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
YEAR
28. PLACE WHERE MARRIAGE OCCURRED
10 CIVIL
A. STATE NEW YORK B. COUNTY f'lr.LT ~ ~tI.2SS
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
./
o CITY OF ltl--fOWN OF 0 VILLAGE OF
SPECIFY \;\) ItPP; Nr;-t~ f1\tLS.
I:::LS. Iv II " 2..:)'CI c
ZIP
31. WITNESS TO CEREMONY ._,
NAME (PRINT) tt~~~ e~~v
SIGNATURE~ -v...;~-./
