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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
COUNTY Dutchess
gll~~grN W3ppinger
~~~~~~R 1368
NUMBER 9'1
1 " A. FULL NAME
VVilliHtE\Ncslcy F~~URNAME
FIRST
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE)
D. SOCIALSECURITYNUMBER 269 88 9371
2. RESIDENCE A. "IV B. n. ..~l-.cSS
1""11 /STATE) ~,
C CHECK ONE D CITY ~ TOWN D VILLAGE
AND
SPECIFY W3ppingor
D, STREET ADDRESS 104 Popula Boul~vard ZIP 12590
E IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? D YES oil] NO
MOOie / ~$ / y1~76
3. A AGE 32
4. EMPLOYMENT
3B. DATE OF BIRTH
A. USUAL OCCUPATION ^ttorney
B. TYPE OF INDUSTRY OR BUSINESS Law
5. PLACE OF BIRTH ~W' Ql;)~
'( . A'Tt cl Y IF NOT USA)
6. FATHER
A. NAME Jamcs Michael Frame
B. COUNTRY OF BIRTH U 53 .A-
7. MOTHER
A MAIDEN NAME Frances Ann Doria
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
DEATH
o
o
o
(2) D DEATH
B. HOW DID LAST MARRIAGE END? (3) D DIVORCE
(3) D ANNULMENT
/ /
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
I
STATE FILE NUMBER
(THIS SPACE FOR STA TE USE ONL Y)
'I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
--.J
11. A. FULL NAME
KristO;l;;'D"r;:>,ptrioio EIlQ'{~9QSURNAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE)
D. SOCIAL SECURITY NUMBER 067 72 4704
12. RESIDENCE A, N~STATE) B. O~gp
C. CHECK ONE D CITY ~ TOWN D VILLAGE
AND
SPECIFY Wallkill
D STREET ADDRESS 305 ShenA/ood Dri\le North ZIP 10941
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? D YES III NO
O&TH ~~AY /-f ~lp
13. A. AGE 32
14. EMPLOYMENT
3B. DATE OF BIRTH
A. USUAL OCCUPATION Graphic Designer
B. TYPE OF INDUSTRY OR BUSINESS Manhattan Beer
15. PLACE OF BIRTH 1~~Rn\l~~ Fl9ri~r
. SA/ CO RY IF N T U A
16. FATHER
,A. NAME Matthew Joseph Enering
B. COUNTRY OF BIRTHU S A
17 MOTHER
A MAIDEN NAME Cherylanne Foster Ste\lens
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
DEATH
o
o
(3) D DIVORCE
o
B. HOW DID LAST MARRIAGE END?
(3) D ANNULMENT (2) D DEATH
/ /
- YEAR
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 OECREE PLACE ISSUEO AGAINST WHOM
(MONTH. DAY, YEAR) (CITY/COUNTY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
1ST
2ND
3RD
4TH
I duly swear/affirm, depose and say, that
as to my right to enter into the marr!!!:
21. SIGNATURE OF GROOM ~
23. SUBSCRIBED AND SWORN TO/AF
SIGNATURE OF TOWN OR CITY
D 0 1ST
D D 2ND
D D 3RD
D D 4TH
e best of my knowledge and belief that the information I provided is true and
~ .
22. SIGNATURE OF BRIDE ~
D D
D D
D D
D D
at no legal impediment exists
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.
D 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
{ SEAL} SNIAGMNEAT(PURRIEN: ~C.'i~n TIME MONTH DAY YEAR
..- AC~ DATE 07'24'2008
MAILING ADDRESS/, 09:24AM
"-v-I STR~ MiddlE'hll"h Rd, \^/~rg~~r!=: F~II!=:'ST~r 1?!1~Qp PM 07 25 2008
~~~R~~Ri~~~ lo~O~~~N~Zig. 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
SONS NAMED ABOVE ON THE TIME MO. DAY YEAR 0 J1{ RELIGIOUS
DATE AND AT THE TIME AND 2."'0 A
PLACE INDICATED. '-:;; .. 1 - z ~ - 08. 9 D OTHER. SPECIFY
~~t~n~~~T 1t, <;,. Q",v. M. C AJtL Lv"" c1l<.,...} TITLE
S. IGNATURE ~ 7t ;;./ -i._~A--- ,oj- DATE
MAILING ADDRESS ~
(I <( 5",-, \-~ C~"'J~ ~ s-i. Gos ~ c...J fJ~ W ''( c,.'/,Vl..
STREET CITYfTOWN
30. WITNESS TO CEREMONY
NAME (PRINT) /'1.#/" e-L ;J Ce:;.r"';1--
Z;tu..;6 / ~
SIGNATURE~
nnu _OA /('\~ I?r'ln~'
MONTH
YEAR
09
22 2008
28. PLACE WHERE MARRIAGE OCCURRED
1 D CIVIL
A. STATE NEW YORK B. COUNTYOa.(\N'!I 'i.
~c.. \... :z.
7!zr%X
I 6~ Z 'f
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
D CITY OF D TOWN OF ~ VILLAGE OF
SPECIFY 0'0$" 'e.....J
STATE
NAME (PRINT)
SIGNATURE~