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Dutchess
COUNTY . - . .
vvapplnger
CITYrroYf3
DISTRICT 58
~~~I~~~R21
NUMBER
~ I A It:. Ut- Nt:.W YUH~
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Vincent DePaul Ennis
(THIS SPACE FOR STA TE USE ONL Y)
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Danielle Christine Corrado
~
1. A. FULL NAME
11. A. FULL NAME
FIRST
MIDDLE
CURRENT SURNAME
FIRST
MIDDLE
CURRENT SURNAME
0-
N
12590
B. BIRTH NAME (MAIDEN NAME), II"-DIFF6RENT
t::.nnls
C. SVS~~ItM~E~~l~W~~~SE:090-68-6540
D. SOCIAL SEC\J{l1lY NUMBER F'"\ t t
1\1 Y uU C less
12. RESIDENCE A. (STATE) 01' B. (COUNTY)
C. ~~6CK ~appmagr 0 TOWN 0 VILLAGE
SPECIFY 302 Popula Blvd. 12590
D. STREET ADDRESS ZIP
.,
E. IS RE~NCE WITHIN LIMITS OF CITY OR INCORPORATarILLAGE)d6 0 Y~llh~O
13. A. AGE 3B. DATE OF BIRTH - ~
MONTH DAY YEAR
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSEl()6b- ( 4-06tlb
D. SOCIAL SE<;'Uf\1l)' NUMBER D t..
1\1 Y utCI less
2. RESIDENCE A. B.
(STATE).t (COUNTY)
C. CHECK ON~., [J. CITY 0 TOWN 0 VILLAGE
AND vvapplnger
SPECIFY 302 Po pula Blvd.
D. STREET ADDRESS ZIP
E. IS RE~ONCE WITHIN LIMITS OF CITY OR INCORPORATEDOUf^GE? 27
3. A. AGE 3B. DATE OF BIRTH /
MONTH DAY
.,
Y/ lf9~
YEAR
4. EMPLOYMENT
14. EMPLOYMENT
Maintenance
A. USUAL OCCUPATION Construction
B. TYPE OF INDU,s;rRY OR BUSIIlIG\l~
I..weens I\J Y
5. PLACE OF BIRTH I
(CITY. STATE I COUNTRY IF NOT USA)
6. FATHER G E'
A NAM Joseph uyon nnls
. E USA
Accountant
A. USUAL OCCUPATION A l'
r\l,;l,;UUrllll!:l
B TYPE OF INDt.t'"~fr9l'efl~'T\l'VS
15. PLACE OF BIRTH
(CITY. STATE / COUNTRY IF NOT USA)
16. FATHER Michael J. Corrado
A. NAME USA
B. COUNTRY OF BIRTH
B. COUNTRY OF BIRTH
7. MOTHER Patricia Marie Casey
A. MAIDEN NAME USA
I
17 MOTHER Eginia C. Rolla
A. MAIDEN NAME USA
B. COUNTRY OF BIRTH 1
18. NUMBER OF THIS MARRIAGE
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
D~ORCE CIVIL A~ULMENT
D~TH
B. COUNTRY OF 81RTH
8. NUMBER OF THIS MARRIAGE
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIV'ifCE CIVIL AN~ULMENT
D~TH
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
(3) 0 ANNULMENT
/ /
(2) 0 DEATH
B. HOW DID LAST MARRIAGE END?
(3) 0 DIVORCE
(3) 0 ANNULMENT (2) 0 DEATH
/ /
- YEAR
C. DATE LAST MARRIAGE ENDED?
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. STATE/COUNTRY, IF NOT USA) SELF SPOUSE
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) (CITY/COUNTY. STATE/COUNTRY. IF NOT USA) SELF SPOUSE
1ST 0 0 1ST
2ND 0 0 2ND
3RD 0 0 3RD
4TH 0 0 4TH
I duly swellr/affirm. depose and say, that to the best of my knowledge and belief that the information 1 provided is t
as to my nght to enter Into .the m;f'l1j1lge sta~ L'"
(/i.-- ~ - ---..:::.
21. SIGNATURE OF GROOM~' . NATURE OF BRIDE~
USE CURRE N M
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New York 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 purpose of a second or subsequent ceremony.
-^- 24. TOWN OR CITY C ERKC M t 25 A SOLEMNIZATION PERIOD BEGINS
r-~ JO. as erson . .
{ } NAME (PRINn .
SEAL 04/09/2009
SIGNATURE ~ . ATE
'-v-I MA~tf h Rd, gers Falls, NY 12590
STREET ZIP
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER.
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND II AM
PLACE INDICATED. , '.00 PM S
o
o
o
04/09/2009
DATE
by New York Domestic
25. B. SOLEMNIZATION PERIOD
ENDS AT MIDNIGHT ON:
CITYITOWN
26. SOLEMNIZATION OCCURRED
TIME MO. DAY YEAR
STATE
27. TYPE OF CEREMONY
o ~ RELIGIOUS
9 0 OTHER, SPECIFY
06
08 2009
YEAR
MONTH
DAY
YEAR
28. PLACE WHERE MARRIAGE OCCURRED
10 CIVIL
A. STATE NEW YORK B COUNTY.DuJ-c.kpss
~~
oq
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF ~ TOWN OF 0 VILLAGE OF
TITLE~IV'I (~\I<: PtQ.~t'.,i-
SIGNATURE ~
MAILING ADDRE
'Y.() ,
STREET
30. WITNESS TO CEREMONY
NAME (PRINn ~UIIa. "'"
SIGNATURE~
DOH-98 (03/2006)
SPECIFY &-s-t *"~ k k1. \ 1
C. G~jIl"!f::.
(" '"
NAME (PRINn
SIGNATURE~