021
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New Yo State of the bride and groom named above by any person authorized
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 urpose of a second or subsequent ceremony.
~ 24. TOWN OR CITY CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
} NAME (PRINT) J~C. Masterson
{SEAL SIGNATURE~ ~l.~ DATE 03/26/2010 TIME MONTH YEAR
'-..t-I MA210GrX~dr~bush Rd, Wappingers Falls, NY 12590 01 :09:~ 03 27 2010
STREET CITYITOWN STATE ZIP
~~:R~:RT~~J 10~0~~~N~E~ 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY ~./
SONS NAMED ABOVE ON THE TIME MO. Y YEAR 0 0 RELIGIOUS 1 ip-"CIVIL
DATE AND AT THE TIME AND 4. ~ _
PLACE INDICATED. J /'" PM 9 0 OTHER, SPECIFY
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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDA VIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Shane Anthony Post
MIDDLE CURRENT SURNAME
couNTYDutchess
CITYrrOWN Wappinger
~~~:~c;1368 .
~5~~J~R21
1. A. FULL NAME
FIRST
I
STATE FILE NUMBER
(TH/S SPACE FOR STATE USE ONL Y)
I
B. BIRTH NAME. IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSEil-25 61 9720
D. SOCIAL SECURITY NUMBER 0 - -
2. RESIDENCEA.NY B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY 0 TOW~O VILLAGE
~~~CIFY WappinQers Falls
D. STREET ADDRESS 10 No. Gilmore Blvd ZIP 12590
E. IS RESIDENCE WIlHIN LIMITS OF CITY OR INCORPORATED VILLAGE? ""0 YES 0 NO
08 /22 /1985
MONTH DAY YEAR
3. A. AGF24
3B. DATE OF BIRTH
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Avary Rae Bradford
MIDDLE CURRENT SURNAME
-1
4. EMPLOYMENT
A. USUAL OCCUPATION Foreman
B. TYPE OF INDUSTRY OR BUSINESS Tree Care
5. PLACE OF BIRTHBloomfield. NM
(CITY, STATE / COUNTRY IF NOT USA)
6. FATHER
A. NAME James A. Post
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Shawn Marie Coleman
B. COUNTRY OF BIRTH USA
6. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
DEATH
o
11. A. FULL NAME
FIRST
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) (CrrYICOUNTY. STATElCOUNTRY. IF NOT USA) SELF SPOUSE
1ST
2ND
3RD
4TH
I duly swear/affirm, depose and s
as to my right to enter into the
21. SIGNATURE OF GROOM
B. BIRTH NAME (MAIDEN NAMEl;..t" DIFFERENT
C. SURNAME AFTER MARRIAGe':OSt
(OPTIONAL - SEE REVERS'997 -72-2870
D. SOCIAL SECURITY NUMBER
12. RESIDENCE ~Y putchess
(STATE) J (COUNTY)
C. CHECK P~IJ .0 CITY 0 JPWN" 0 VILLAGE
~~clF1~applngers ra IS
JUNO. ljllmore Blvd 12590
D. STREET ADORES ?I
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 Y5S"'!~6NO
13. A. AG~3 38. DATE OF BIRTH 04 ~ ~
MONTH DAY YEAR
14. EMPLOYMENT
A. USUAL OCCUPATlotRispatcher
utTIce ~qUlpment
B. TYPE OF INDIlilTRY qRI~USINESS
15. PLACE OF BIRT..r::ougn~eepsle, NY
(CITY. STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAM~ary Ray Bradford
. B. COUNTRY OF BIRTtV S A
17. MOTHER 'I RD'
A. MAIDEN NAMEJen yn ae aVls
B. COUNTRY OF BIRTtV S A
1
1B. NUMBER OF THIS MARRIAGE
19. PREViOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DQ'ORCE CIVIL A5NULMENT
D(fTH
(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) (CITY/COUNTY. STATElCOUNTRY, IF NOT USA) SELF SPOUSE
o 1ST
o 2ND
o 3RD
o 4TH
alief that the information I provided is true and that I declare that no legal im
o
o
o
o
exists
22. SIGNATURE OF BRIDE ~
by New York Domestic
MONTH
YEAR
05
25 2010
26. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY\) 1,..'),,\ r=.. rz.-.,
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C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF ~WN OF 0 VILLAGE OF
SPECIFY ~ 0 t.. .\4~ \' 6- (l....
SIGNATURE
Mt~G ?-DRES
STREET
30. WITNESS TO
NAME (PRINT) .
ZIP
31. WITNESS TO CEREMONY
NAME (PRINT) -::s: .
SIGNATURE~