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23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE M
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New State of t bride and groom named above by any person authorized by New York Domestic
W Relations Law !i11to perform marriage ceremonies within New York State. THIS LICENSE VALID IN NEW YORK STATE ONLY.
en 0 If checked, this license is to be used only for the purpose of a second or subsequent ceremony.
Z ~ 24. TOWN OR CI1J&lf\?,K C. Masterson 25. A. SOLEMNIZATION PERIOD BEGINS
W { } NAME (PRINT)
~ SEAL SIGNATURE ~ DATE 08/02/200 TIME MONTH YEAR MONTH DAY YEAR
"-v-I MAI~tm!fd ppinger Falls, NY 12590 06:5~~ 08 03 2006 10 01 2006
STREET CrrYlTOWN STATE ZIP
I CERTIFY THAT I SOLEMNIZED 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
THE MARRIAGE OF THE PER.
SONS NAMED ABOVE ON THE TIME M. DAY YEAR 00 RELIGIOUS
DATE AND AT THE TIME AND '" 0 (f AM
PLACE INDICATED. (/-. PM 9 0 OTHER, SPECIFY
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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Patrick Kevin Paredes
MIDDLE CURRENT SURNAME
COUNTY Dutchess
CITYfTOWN Wappinger
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1 . A. FULL NAME
FIRST
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
I
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL' SEE REVERSE) 126-78-0014
D. SOCIAL SECURITY NUMBER
2. RESIDENCEA. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
~~~CIFY WappinQer
D. STREET ADDRESS 2478 Route 9 D ZIP 12590
E. IS RESIDENCE WITHIN UMITS OF CITY OR INCORPORATED VIlLAGE? 0 YES d NO
03 / 08 / 197
MONTH DAY YEAR
3. A. AGE 27
3B. DATE OF BIRTH
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Monica Lee Jones
MIDDLE CURRENT SURNAME
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4. EMPLOYMENT
A. USUAL OCCUPATION Network Administrator
B. TYPE OF INDUSTRY OR BUSINESS Information Technology
5. PLACE OF BIRTH Bronx, New York
(CrrY, STATE I COUNTRY IF NOT USA)
6. FATHER
A. NAME John Kevin Paredes
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Catherine Teckla Twarog
B. COUNTRY OF BIRTH USA
B. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIV08CE CIVIL ANN~LMENT
D~H
11. A. FULL NAME
FIRST
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
(2) 0 DEATH
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Paredes
(OPTIONAL. SEE REVERSE) 009-50-7494
D. SOCIAL SECURITY NUMBER
12. RESIDENCEA. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY r:! TOWN 0 VilLAGE
~~CIFY WapQin-.ger
D. STREET ADDRESS 2478 Route 9 D ZIP 12590
E. IS RESIDENCE WITHIN UMITS OF CITY OR INCORPORATED VIlLAGE? 0 YES ~ NO
04 /25 /1979
MONTH DAY YEAR
13. A. AGE 27
3B. DATE OF BIRTH
YEAR
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
10. IF PREVIOUSLY DIVORCED OR ANNULlLED, PROVIDE THE FOLlLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CrrYICOUNTY, STATEICOUNTRY. IF NOT USA) SELF SPOUSE
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14. EMPLOYMENT
A. USUAL OCCUPATION Math Teacher
B. TYPE OF INDUSTRY OR BUSINESS Beacon City School Dist.
15. PLACE OF BIRTH Troy, New York
(CITY, STATE I COUNTRY IF NOT USA)
16. FATHER
A. NAME Kenneth Lawrence Jones Iii
. B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME Nancy Lee Anderson
B. COUNTRY OF BIRTH USA
1
18. NUMBER OF THIS MARRIAGE
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIV8RCE CIVIL AN~ULMENT
D~H
(3) 0 ANNULMENT (2) 0 DEATH
/ /
. -- YEAR
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
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20. IF PREVIOUSLY DIVORCED OR ANNULlLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITYICOUNTY, STATElCOUNTRY. IF NOT USA) SEL. SPOUSE
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2ND
3RD
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al impediment exists
25. B. SOLEMNIZATION PERIOD
ENDS AT MIDNIGHT ON:
l~CIVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY j)i./ 7C#e5)
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NAME (PRINT)""
SIGNATURE~ '
bOH-9B 10312006\
LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF J( TOWN OF 0 VILLAGE OF
SPECIFY WfJp P , ",J t; t:: /L,
NAME (PRINT)
SIGNATURE~