036
+
o
en
L!)w
N!;;:
.,.....t;;
>-
Z
>- .!!2 ~
mco :>
~LL <C
~~ C
5Q)wU::
~ ~ LL
'" Cd <C
Z'-~
g ;:
Ii CO g
tii>~
a>U
w
a:
w"O
" CO
~ 0
~o::
::E.c
~ en
w :J
>-.!:)
~ Q)
U- -
F
a:
w
U"
w
a:
w
I
;:
'"
'"
w
a:
o
o
<(
>-
U-
o
W
0-
'"
+
jiE:i:Z w
~i~
~~~ ~<C
>-wz
~d~ 0
~~g u::
~~~ ~
[to", W
0>->-
W~C5 0
t-ffilO
~~~
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
l\J1ir.h::ip.1 Rnhp.rt Volkm::inn
MIDDLE CURRENT SURNAME
1ST 0 0 1ST
2ND 0 0 2ND
3RD 0 0 3RD
~ 0 0 ~
I duly swear/affirm, depose and say, that to the best of my knowledge and belief that the information I provided is true a
as to my right to enter into the marna~e st. '~ /
21. SIGNATURE OF GROOM ~ ~ . / ~ --- 22. SIGNATURE OF BRIDE
'~~RE U
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFOF.l "f/)~ ./') L ,,~,,)
SIGNATUREOFTOWNORCITYCLERK~ ~ I _Ij.~_c::::f-L_
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 CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
COUNTY Dutchess
CITYiTOWN Wappinger
~~~:~c: 1 368
~~~~;~R36
1. A. FULL NAME
FIRST
0-
N
B. BIRTH NAME. IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL' SEE REVERSE)
D. SOCIAL SECURITY NUMBER 078-72-6169
2. RESIDENCE A. NY B. nlltr.hp.!=:!=:
(STATE) (COUNTY)
C. CHECK ONE 0 CITY..tJ TOWN 0 VILLAGE
AND W .
SPECIFY ::irrmgp.r
o STREET ADDRESS 45 Middlebush Road ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES ~ NO
17 / O!1 / 1 !=lR 1
MONTH DAY YEAR
3. A. AGE 26
3B. DATE OF BIRTH
4. EMPLOYMENT
A. USUAL OCCUPATION Ser.llrity nffir.p.r
B. TYPE OF INDUSTRY OR BUSINESS Nuclear
5. PLACE OF BIRTH r.itv nf POlJohkeensie, New York
(CIrT. STATE / COUNT'i'1Y IF NOT L1SA)
6. FATHER
A. NAME lohn loserh \/olkm::inn
B. COUNTRY OF BIRTH l J S A
7. MOTHER
A. MAIDEN NAME Irp.np. M::iry Gamhichler
B. COUNTRY OF BIRTH II S A
B. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o
o
DEATH
o
(2) 0 DEATH
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
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
w
en
z
w
o
::i
~
{ SEAL }
'-v-I
NAME (PRINT)
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Sheena Angelica White
MIDDLE CURRENT SURNAME
I
--!
11. A FULL NAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C SURNAME AFTER MARRIAGE Vol k man n
(OPTIONAL' SEE REVERSE)229 25 5113
D. SOCIAL SECURITY NUMBER --
12. RESIDENCE ANY B Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
~~~CIFY Wappinger
D. STREET ADDREss45 Middlebush Road
ZIP 12590
DYES~NO
/1'982
YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VillAGE'
13. A. AGE ?6 3B. DATE OF BIRTH 01 /06
MONTH DAY
14. EMPLOYMENT
A. USUAL OCCUPATION Student
B. TYPE OF INDUSTRY OR BUSINESS Education
15. PLACE OF BIRTH Fairfax County, Virqinia
(CITY, STATE / COUNTRY IF NOT USA)
16. FATHER
A NAME Kenneth Joseph White
. B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME Gisele Marie Savoie
B. COUNTRY OF BIRTHCanada
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 DID LAST MARRIAGE END? (3) 0 DIVORCE (3) 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? / (.
MONTH DAY YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
~
20. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF OECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY/COUNTY. STATE/COUNTRY. IF NOT USA) SELF SPOUSE
o 0
o 0
o 0
o 0
impediment exists
DATE
04/24/2008
by New Yark Domestic
TIME
MONTH
MONTH
YEAR
YEAR
DATE
09: 1 OAM
PM
23 2008
2008
06
04
25
ITY N
26. SOLEMNIZATION OCCURRED
TIME MO. DAY YEAR
TATE
27. TYPE OF CEREMONY
o ~ RELIGIOUS
9 0 OTHER, SPECIFY
10 CIVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY~cflli:~S
STR
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
NAME (PRINT)
1~~""O
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF ~TOWN OF 0 VILLAGE OF
SPECIFytHsr FI stl KI ~L
SIGNATURE