Jason Paul Ellis and Keren N. Form were married on January 12, 2007 in Bronx, New York City in 2006.
This marriage license was filed in Bronx with license number 26506.
| Groom |
| First Name |
Jason Paul |
| Last Name |
Ellis |
| Bride |
| First Name |
Keren N. |
| Last Name |
Form |
| License Details |
| Borough |
Bronx |
| Year |
2006 |
| Marriage Date |
January 12, 2007 |
| License # |
26506 |