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COUNTY Dutchess
CITYrrOWN Wappinger
~~~:~c~ 1368
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DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Ronald Kenneth Ferrante
MIDDLE CURRENT SURNAME
FIRST
(THIS SPACE FOR STATE USE ONL Y)
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Kristv Santoianni
MIDDLE CURRENT SURNAME
~
1. A. FULL NAME
11. A. FULL NAME
FIRST
0-
N
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Ferrante
(OPTIONAL. SEE REVERSE)074 64 6724
D. SOCIAL SECURITY NUMBER --
12 RESIDENCEA.NY B.Dutchess
(STATE) (COUNTY)
C. CHECK ONE D CITY ~ TOWN D VILLAGE
~~~CIFY WappinQer
D. STREET ADDREss53 Martin Drive
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL' SEE REVERSE)048 74 1750
D. SOCIAL SECURITY NUMBER --
2 RESIDENCE A. CT B. Fairfield
(STATE) (COUNTY)
C. CHECK ONE D CITY ~ TOWN D VILLAGE
~~~CIFY Bethel
D. STREET ADDRESS 21 Shelter Rock Road ZIP 06801
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? DYES '6 NO
3. A. AGE ?A 3B. DATE OF BIRTH 07 /01 /1980
MONTH DAY YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE?
13. A. AGE 28 3B. DATE OF BIRTH 03 /f 1
MONTH DAY
ZIP 12590
DYES'6 NO
;(980
YEAR
4. EMPLOYMENT
A. USUAL OCCUPATION Police Officer
B. TYPE OF INDUSTRY OR BUSINESS Law Enforcement
5. PLACE OF BIRTH New Haven. Ct
(CITY, STATE / COUNTRY IF NOT USA)
6. FATHER
A NAME Ronald Francis Ferrante
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Linda Marie Carris
B. COUNTRY OF BIRTH USA
B. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
14. EMPLOYMENT
A. USUAL OCCUPATION Attornev
B. TYPE OF INDUSTRY OR BUSINESS Law
15. PLACE OF BIRTH Manhattan , Ny
(CITY, STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Ralph Santoianni
'B. COUNTRY OF BIRTHU S A
17. MOTHER
A. MAIDEN NAME Lorraine Browning
B. COUNTRY OF BIRTHU S A
18. NUMBER OF THIS MARRIAGE 1
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
DEATH
o
DEATH
o
B. HOW DID LAST MARRIAGE END? (3) D DIVORCE
C. DATE LAST MARRIAGE ENDED?
(2) D DEATH
(3) D ANNULMENT (2) D DEATH
/ /
- YEAR
(3) D ANNULMENT
/ /
B. HOW DID LAST MARRIAGE END? (3) D DIVORCE
C. DATE LAST MARRIAGE ENDED?
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? DYES D 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
0:'
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D D 1ST D
D D 2ND D
D D 3RD D
D 4TH
belief that the information I provided is tru
21. SIGNATURE OF GROOM~
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SEC
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFO E M
SIGNATURE OF TOWN OR CITY CLERK~ 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 ~11 to perlorm marriage ceremonies within New York State. THIS LICENSE VALID IN NEW YORK STATE ONLY.
D " 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, M terson
{TIME MONTH DAY YEAR MONTH
SEAL SIGNATURE ~. DATE 09/10/2008
'-v-I MAI~~G~Ft1at~ ush Rd, Wappingers Falls, NY 12590 10:38AM 09 11 2008 11 09 2008
STREET CITYITOWN STATE ZIP PM
I CERTIFY THAT I SOLEMNIZED 26 SOLEMNIZATION OCCURRED 27~TYPE F CEREMONY
THE MARRIAGE OF THE PER. .
SONS NAMED ABOVE ON THE TIME MO. DAY YEAR 0 RELIGIOUS 1 D CIVIL
~tl6E~~gIC'i..~ET6'E TIME AND, '3cJ~M /3 ~ 9 D OTHER, SPECIFY
~~~:~~~~~j fJ{5(;!e. fktftVcis ? 13t:u~w TITLE t. e. P!215rr'
SIGNATURE~ ~.~I? I1npfJW 9t3~f'
MAILlN/ADD~ 4f. Wa ~ft '
STREET CITYrr STATE
30. WITNESS TO CEREMONY l)
(~'" ~~..., ,"'.
NAME (PRINT) ~ ......,
c:.,......r,,/"l~ ()
SIGNATURE~ - ...........:::n-
DOH.98 (0312006)
YEAR
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY~tt.lCJftiZ
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY) .
D CITY OF D TOWN OF ~LAGE OF
SPECIFY ~AflO('~~RS ~5
~~k
31.
NAME (PRINT)
SIGNATURE~