No Record Certification - Marriage
STATE OF NEW YORK
Department of Health
No Record Certification. Marria~e
District No.
THIS IS TO CERTIFY that a search has been made in this office for the marriage
record of
and
which marriage is said to have been solemnized on
at
(Date Marriage Solemnized)
, State of N ew York and that such record is not
(Place Marriage Solemnized)
on file in this office. Search has been made for the period from
Month Day Year
to /
Month
/
Day Year
day of
19
Witness my signature this
Clerk
City }
Town
Village
DOH-3654 (4/93)
of
, New York
VS-13