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STATE OF NEW YORK
COllNTY Dutchess DEPARTMENT OF HEALTH
l"; . '..:rri,'roWN WappinQer
~~~[;i 1368 AFFIDAVIT, LICENSE and
~5~~J~R 101 n/9/o(" CERTIFICATE OF
~ORRECTED BY OFFICIANT ca..., MARRIAGE
FROM THE GROOM
FIRST Chris~er Euge~~RR~WRL
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FUll NAME
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE) 054 74 4399
D. SOCIAl. SECURITY MJMlIER --
2. RESlDENCEA. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
1, ~'FY PouQhkeepsie
). STREET ADDRESS 2846 Route 9 D ZIP 12590
E. IS RESIDENCE WITHIN UMITS OF CIlY OR INCORPORATED VILLAGE? 0 YES r:1 NO
6&AGE 27 38. DATE OF BiRTH 07 / 11 / 197
MONTH DAY YEAR
PLOYMENT
A. USUAL OCCUPATION Territory ManaQer
B. TYPE OF INDUSTRY OR BUSINESS Laerdal Med. Corp.
5. PLACE OF BIRTH Yonkers, New York
(CIlY, STATE I COUNTRY IF NOT USA)
8. FATHER
A. NAME Bradley William Byron
B. COUNTRY OF BIRTH U S A
7. MOTHER
A. MAIDEN NAME carol~n Jean Heine
B. COUNTRY OF BIRTH U A
B. NUMBER OF THIS MARRIAGE 1
9. ~~~~~~R~PIflRlr&S MARRIAGES WHICH ENDED BY
DIVoaCE CIVIL ANN~LMENT
DEAlr
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE (3) 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? / /
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) (CIlYICOUNTY, STATEICOUNTRY, IF NOT USA) SELF SPOUSE
1ST
2ND
3RD
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STATE FILE NUMBER
(THIS SPACE FOR STA TE USE ONL Y)
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/: Y.- ;~. 0 10 ~:;; ..- 000 4 :;:~. H:n ,,1
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FROM THE BRIDE
She~~ Tyler Joh~~~~ SURNAME
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11. A. FUll NAME
FIRST
B. BIRTH NAME (MAIDEN NAMEl, IF DIFFERENT
C. SURNAME AFTER MARRIAGE Byron
(0PT10NAL . SEE REVERSE) 118 68 9376
D. SOCIAL SECURIlY NUMBER --
12. RESIDENCEA. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY rY TOWN 0 VILLAGE
r~ClFY PouQhkee~sie
D. STREET ADDRESS 2846 Route 9 p ZIP 12590
E. IS RESIDENCE WITHIN UMITS OF CITY OR INCORPORATED VILLAGE? 0 YES ~ NO
13. A. AGE 23 38. DATE OF BIRTH 11 /29 /1982
MONTH DAY YEAR
14. EMPLOYMENT
A. USUAL OCCUPATION Business Mana~er
B. TYPE OF INDUSTRY OR BUSINESS Lucy's etail Store
15. PLACE OF BIRTH Poughkeepsie, New York
(CIlY, STATE I COUNTRY IF NOT USA)
18. FATHER
A. NAME Laurence Walter Johnson
'B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME Darlene Frances Nevins
B. COUNTRY OF BIRTH USA
1
18. NUMBER OF THIS MARRIAGE
19. ~~~~~~~PIflRlr8us MARRIAGES WHICH ENDED BY
DIV8RCE CIVIL AN'8'LMENT
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
..
20. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITYICOUNTY, STATEICOUNTRY, IF NOT USA) SELF SPOUSE
1ST
2ND
3RD
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Yorlt Domestic
YEAR MONTH
2006 09 17 2006
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COU~~S'
C. LOCATION OF CEREMONY j~~f2.
(CHECK ONE AN~~'FY) :..;/fP;/
o CITY OF ~OJrOF
SP!FY~'" M~~&-
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SFfF04J.BI'i-~M
The Reverend Paul B. Clayton, Jr., Ph. D.
-4 T01mlelld Farm Road
LaGrangeville, New Yark 12540
(845) 227--62-47 ~I: pbclayton@aol.com
November 6, 2006
Mr. Allen Trombley
New York State Department of Health
Vital Records Section
Marriage Registration Unit
P. O. Box 2602
Albany, NY 12220-2602
Dear. Mr. Trombley:
On Saturday, August 12, 2006, I, being a priest of the Episcopal Diocese of New York, solemnized the
marriage of Christopher Eugene Byron and Shelby Tyler Johnson, at the Episcopal Church of St. Nicholas
on Hudson In New Hamburg, New York. However, on the Certificate of Marriage I filled in line 28,
subsection C Incorrectly, stating that the marriage had occurred In the Village of New Hamburg. Line 28,
subsection C should read, ''Town of Poughkeepsie.. I was in error thinking that New Hamburg was an
Incorporated village In the Town of Poughkeepsie.
Secondly, St. Nicholas is a very small congregation that does not have official parish letterhead stationery.
Thus this letter is written on my personal letterhead stationery.
Faithfully yours,
~~CI~:.1IA.~.
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,.(',',t...,..,Y''''rk
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The Reverend Paul B. Clayton, Jr., Ph. D.
4 Townsend Farm Road
LaGrangeville, New York 12540
(845) 227,6247 E-mail: pbclayton@aol.com
November 6, 2006
Mr. Allen Trombley
New York State Department of Health
Vital Records Section
Marriage Registration Unit
P. O. Box 2602
Albany, NY 12220-2602
Dear. Mr. Trombley:
On Saturday, August 12, 2006, I, being a priest of the Episcopal Diocese of New York, solemnized the
marriage of Christopher Eugene Byron and Shelby Tyler Johnson, at the Episcopal Church of St. Nicholas
on Hudson in New Hamburg, New York. However, on the Certificate of Marriage I filled in line 28,
subsection C incorrectly, stating that the marriage had occurred in the Village of New Hamburg. Line 28,
subsection C should read, "Town of Poughkeepsie." I was in error thinking that New Hamburg was an
incorporated village in the Town of Poughkeepsie.
Secondly, St. Nicholas is a very small congregation that does not have official parish letterhead stationery.
Thus this letter is written on my personal letterhead stationery.
Faithfully yours,
rG.. L a. L?t...;ta...~.
The Rev'd Dr. Paul B. Clayton, Jr.
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CLAUD!;" CARSINi
Reg. Noo C::~913176
~~c~:?:,f_~,~;~~-h~,~~',?..~! Nr:w York
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The Reverend Paul B. Clayton, Jr., Ph. D.
4 Townsend Farm Road
LaGrangeville, New York 12540
(845) 227,6247 E~ail: pbclayton@aol.com
August 16, 2006
Town of Wappinger
Town Clerk's Office
20 Middlebush Road
Wappinger Falls, NY 12590
To Whom It May Concern:
On Saturday, August 12, 2006, I, being a priest of the Episcopal Diocese of New York, solemnized the
marriage of Christopher Eugene Barton and Shelby Tyler Johnson, at the Episcopal Church of St. Nicholas
on Hudson in New Hamburg, New York. However, on the Certificate of Marriage I filled in line 28,
subsection C incorrectly, stating that the marriage had occurred in the Village of New Hamburg. Line 28,
subsection C should read, "Town of Poughkeepsie." I was in error thinking that New Hamburg was an
incorporated village in the Town of Poughkeepsie.
E:Y;"a. ~r,~. +
The Rev'd Dr. Paul B. Clayton, Jr.
COP'!
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_~IISTATE OF NEW YORK
..., DEPARTMENT OF HEALTH
Corning Tower
The Governor Nelson A. Rockefeller Empire State Plaza
Albany, New York 12237
Antonia C. Novello, M.D., M.P.H., Dr.P.H.
Commissioner
Dennis P. Whalen
Executive Deputy Commissioner
November 20, 2006
Groom:
Bride:
Christopher Eugene Byron
Shelby Tyler Johnson
Dear Town/City Clerk:
Enclosed is a copy of the marriage referred to by the above file in your office.
Correction to the original has been made based on:
D Affidavit
D Court Order
[gI Officiant's Statement
D Signature on original marriage affidavit
D Statement verified by City/Town Clerk
D Other: Supplemental
Please file this amended record along with the supporting documentation.
If you have any questions, please call us at (518) 486-3301.
Sincerely,
Arleen Meres
New York State Dept. of Health
Vital Records Section
Marriage Registration Unit
P.O. Box 2602
Albany, NY 12220-2602
Enclosure
. .
~ '
_~IISTATE OF NEW YORK
.,.., DEPARTMENT OF HEALTH
Corning Tower
The Governor Nelson A. Rockefeller Empire State Plaza
Albany, New York 12237
February 13, 2007
Groom:
Bride:
Christopher Eugene Byron
Shelby Tyler Johnson
Dear Town/City Clerk:
Enclosed is a copy of the marriage referred to by the above file in your office.
Correction to the original has been made based on:
o Affidavit
~ Officiant's Statement
o Signature on original marriage affidavit
o Statement verified by City/Town Clerk
o Other: Supplemental
Please file this amended record along with the supporting documentation.
If you have any questions, please call us at (518) 486-3301.
Sincerely,
Arleen eres
New York State Dept. of Health
Vital Records Section
Marriage Registration Unit
P.O. Box 2602
Albany, NY 12220-2602
Enclosure