012
Q.
N
+
C'?
C'f)
J.{)
Nt!:'
...-"
'"
>-
Z
-
(,) I-
~~ :>
~Q) <(
1Il~ C
g Q) w -I.L
:> "
~ojl.L
~Ii <(
~.cg
>-t~
!Q 0 (j
~Z
W Q)
Q >
ii' 0
~()
::;
LL. CO
o Q)
~ l/)
<3 Q)
g.c
>-
a:
W
()
W
a:
W
:I:
3:
lJ)
lJ)
W
a:
o
o
<(
it
u
W
0-
lJ)
w
en
z
w
(.)
::i
+
z' .
~E5 w
>-3:i= ....
~~~ <(
>-wz
lJ)..J::; (.)
:>()W
::;,,6 i:L
~~(() t=
n~~ a:
tEa(/) w
0>->- (.)
w~t3
15~'"
z:;;;
:s I A II: UI- NI:W YUHK.
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Dmitriv Shnevder
MIDDLE CURRENT SURNAME
1ST 0 0 1ST 0 0
2ND 0 0 2ND 0 0
3RD 0 0 3RD 0 0
4TH 0 0 4TH 0 0
I duly sweilr/affirm, depose and say, that to the best of my knowledge and belief that the information I provided is true and that I declare that no legal impediment exists
as to my right to enter mto the "\frlage state. ~~
21.SIGNATUREOFGROOM" \\.~. 22.SIGN.C\~REOFBRIDE'" j:;-~ ...-/-=
USE CURRENT NAM~!J / .). ~.u '51!"'CORRENT NAME
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME //1 ,.., . ~/ ~. 03/13/2009
SIGNATURE OF TOWN OR CITY CLERK ~ _ !- U LA./IJ..AA./ ~ _ DATE
This license authorizes the marriage in New York State of the bride and groom named above by any person authorized by New York Domestic
Relations Law 911 to perform marriage ceremonies within New York State. THIS LICENSE VALID IN NEW ~K 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 CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
{ } NAME (PRINT) J. C. Masterson
TIME MONTH YEAR MONTH
SEAL SIGNATURE ~'. DATE 03/13/2009
MAILING ADDRES 10'07 AM
"-y-I 20 Middl bush Rd, Waooingers Falls, NY 12590 . 03
STREET CITYITOWN STATE ZIP PM
~~~R~~~Ri:~ IO~O~~~N~Z:~ 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
SONS NAMED ABOVE ON THE TIME MO. DAY YEAR 0 0 RELIGIOUS
DATE AND AT THE TIME AND
PLACE INDICATED. 9 0 OTHER, SPECIFY
COUNTY Dutchess
CITYITOWN Wappinger
~~~:kc;1368
~~~li~~R 12
1 . A. FULL NAME
FIRST
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSEn24_65_1440
D. SOCIAL SECURITY NUMBER L.
2 RESIDENCE A. NY B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE D CITY..o TOWN 0 VILLAGE
~~~CIFY East Fishkill
o STREET ADDRESS 8402 Chelsea Cove North ZIP 12533
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? D YES~ NO
11 / 09 /1977
DAY YEAR
3. A. AGE31
3B. DATE OF BIRTH
MONTH
4. EMPLOYMENT
A. USUAL OCCUPATION Engineer
B. TYPE OF INDUSTRY OR BUSINESS Semiconductors
5. PLACE OF BIRTH Minsk, Belarus
(CITY, STATE / COUNTRY IF NOT USA)
6. FATHER
A. NAME Mikhail Yefimovich Shneyder
B. COUNTRY OF BIRTH Belarus
7. MOTHER
A. MAIDEN NAME Larisa Naumovna Gutina
B. COUNTRY OF BIRTH Belarus
8. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
DEATH
o
B. HOW DID LAST MARRIAGE END? (3) D DIVORCE
(3) D ANNULMENT
/ /
(2) D 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) (CITY/COUNTY. STATE/COUNTRY, IF NOT USA) SELF SPOUSE
SIGNATURE~
DOH-98 (03/2006)
(THIS SPACE FOR STA TE USE ONL Y)
L D SUPPLEMENTAL FILE
FROM THE BRIDE
Jelena Olegovna Tuneva
MIDDLE CURRENT SURNAME
.J
11. A. FULL NAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Shneyder
(OPTIONAL - SEE REVERSEb55_94_5991
D. SOCIAL SECURITY NUMBER
12 RESIDENCE A.NY B. Dutchess
(STATE) J... (COUNTY)
C. CHECK ONE D CllY U TOWN 0 VILLAGE
~~~CIFY East Fishkill
D STREET ADDREss8402 Chelsea Cove North
ZIP 12533
DYES '6 NO
)'980
YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE?
13. A. AGE28 3B. DATE OF BIRTH 04 "el3
MONTH DAY
14. EMPLOYMENT
A. USUAL OCCUPATION Biologist
B. TYPE OF INDUSTRY OR BUSINESS Research
15 PLACE OF BIRTH Riga, Latvia
(CITY, STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Oleg Alekseevich Tunev
'B. COUNTRY OF BIRTHRiga, Latvia
17. MOTHER
A MAIDEN NAME Marina Kimovna Surubura
B COUNTRY OF BIRTHSt. Petersburg, Russia
18. NUMBER OF THIS MARRIAGE 1
19. PREVIOUS MARRIAGES
A NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
DEATH
o
B. HOW 010 LAST MARRIAGE END? (3) 0 DIVORCE (3) D ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? / (.
MONTH DAY YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? DYES 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
YEAR
14
2009
12 2009
05
CIVIL
28. PLACE WHERE MARRIAGE OCCURRED
A STATE NEW YORK B. COUN~lJj,'-'~
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY) /
D CITY OF D TOWN OF [B'" VILLAGE OF
SPECIFY w~p,~~~
SIGNATURE~