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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
IM'II" 1'.11 C'tu""rt
. . I M~ff1 ' . a n ~ 'Cl:!mnoNT SURNAME
USE
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This licBnse authorizes the marriage in New Y, k 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 CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
COUNTY Dl.ltchess
CITYITOWN \^'appinger
~~~~~c: 1368
~~~I~J~R 75
1 . A. FULL NAME
FIRST
B. BIRTH NAME. IF DIFFERENT
C SURNAME AFTER MARRIAGE
(OPTIONAL' SEE REVERSE)
D. SOCIAL SECURITY NUMBER 071 72-8534
2. RESIDENCE A. NV B. n, ,t,..hess
TSTATE) '1"coi51WY1
C. CHECK ONE 0 CITY.jlJ TOWN 0 VILLAGE
~~~CIFY W.pping~r
D. STREET ADDRESS 510 Maloney Rd : Art (.;-? ZIP 1 ?RO~
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES ~ NO
MO~ / ~p / y1i79
3B. DATE OF BIRTH
3. A. AGE 28
4. EMPLOYMENT
A. USUAL OCCUPATION Analyst
B. TYPE OF INDUSTRY OR BUSINESS Pharmacelltical
5. PLACE OF BIRTH N~\^' Ro&h~lIe NY
ICI . STATE I OU RY IF NOT USA)
6. FATHER
A NAME William Eugene Stuart, Jr.
B. COUNTRY OF BIRTH I I S A
7. MOTHER
A. MAIDEN NAME Lynne Earle Mllller
B. COUNTRY OF BIRTH USA
8. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
o
(2) 0 DEATH
o
o
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
(31 0 ANNULMENT
/ /
C. DATE LAST MARRIAGE ENDED?
MONTH OA Y 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
2ND
3RD
4TH
I duly swear/affirm, depose and say, th
as to my right to enter into the ma ag
21. SIGNATURE OF GROOM ~
W
en
z
W
o
:i
,-.A-,
{ SEAL }
"-.t-'
NAME (PRINT)
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONLY)
I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Kriliit~n ~~ri~ ,Aleliilii~r~IL~NAME
~
11 A FULL NAME
FIRST
B. BIRTH NAME (MAIDEN NAME). IF DIFFERENT
C. s~S~*~rt.~~~rt~~b~~s~tuart
D. SOCIAL SECURITY NUMBER 127 -64-88~7
12. RESIDENCE A. NY B. D' Itr-h"'liilii
(STATE) TC~
C CHECK ONE 0 CITY eJ TOWN 0 VILLAGE
AND \^, .
SPECIFY erplnCll"r
D STREET ADDRESS!=) 10 M:::Jlnnp.y Rr:I : Art G-? ZIP 1 ?R03
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES ~ NO
13. A. AGE 27 3B. DATE OF BIRTH Q~TH ~~AY /'( ~JiR1
14. EMPLOYMENT
A. USUAL OCCUPATION Teacher
B. TYPE OF INDUSTRY OR BUSINESS Millhrnnk r.sn
15. PLACE OF BIRTH PnllnhkAl"n~il" NY
(CITY, $'fATE / COUNTRY IF'NOT USA)
16. FATHER
A. NAME Jon Monroe Alessandrello
B. COUNTRY OF BIRTHII S A
17. MOTHER
A. MAIDEN NAME Mir.hAlle I ynn SlllIiv::m
B. COUNTRY OF BIRTHII S A
1 B. NUMBER OF THIS MARRIAGE 1
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
o
o
o
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE (3) 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? / (,
MONTH OA Y YEAR
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
1ST
2ND
3RD
4TH
at the information I provided is true
o
o
o
22. SIGNATURE OF BRIDE~
by New York Domestic
TIME
MONTH
YEAR
MONTH
YEAR
DATE
26
2008
08
AM
06:12PM 06
24 2008
ITY WN
26. SOLEMNIZATION OCCURRED
TIME MO. DAY YEAR
'+.'00 A~ D7 I;). v'8
STATE
27. TYPE OF CEREMONY
o ~ELIGIOUS
9 0 OTHER, SPECIFY
10 CIVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY])u1c..hi S"S
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF r:t TOWN OF 0 VILLAGE OF
SPECIFY f),i Iff/' //V 6~/c'
& iC6-lfeSc
OC ()
STREET
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICATED.
29 OFFICIANT -n /J ~. /J'H T rL.. of'. -. /h" D
NAME (PRINT) !'Ie V, f'-..I-ro-r, v. 17m cJ Ah.... S Er r-.) TITLE ..Lt'iTi? R;::-tt;'1"'H ~ ""(sr~,~
SIGNATURE~ ~Q..1 ~ J.l.. ::r. A'V .i-....- DATE ...J utI
MAILING ADDRESS fJ
23 tZ;d,get/levJ ^'cI., fIocewe/1 .JVnc!,m ir IV V
STREET CITYITO N ATE '
Cu"-T
SIGNATURE~
"AU_QR ((\'ll')t"\f)~\
31.
NAME (PRINT)
SIGNATURE