025
+
co
O~
I.!);<'
N(I)
..-
>-
Z
.... I-
rEe :;
~8 <(
~ co e
sQ)UJI.I.
000"'1.1.
1li ~<(
z en ~
Q-o~
~ og
r= 0 ~
asu
w
II:
w
51.x::
oc (.)
~ 0
::;....J
u.
o
w
....
<(
'-'
u:
i=
II:
W
'-'
W
II:
W
I
~
(I)
W
W
II:
o
o
<(
~
13
w
0-
W
+
~:i:Z W
:>t:Q
tii~~ ~
CI:a:- .....
tii~~ 0
i~~ i!
l-Z(I) _
~~15 t:
itow w
0....>-
w~~ 0
b~"'
Z:J~
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Thomas Andrew Crane, III
MIDDLE CURRENT SURNAME
US
23. SUBSCRIBED AND SWORN TO/A IRMED BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New Yor tate of the b de 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
DATE 04/02/200
AM
F 115 NY 12590 04'17PM
STATE ZIP .
27. TYpe: OF CEREMONY
o if RELIGIOUS 1 0 CIVIL
9 0 OTHER, SPECIFY
TITLE 1J1.5/l1fl-
DATEsj'll~g
Iv':
STATE
COUNTY Dutchess
CITYfTOWN Wappinger
~~~:~c; 1368
~~~~~~R 25
1 . A. FULL NAME
FIRST
0-
N
B. BIRTH NAME, IF DIFFERENT
C SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE)096 68 0677
D. SOCIAL SECURITY NUMBER --
2 RESIDENCE A NY B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
~~~CIFY Fishkill
o STREB ADDRESS 14B South Lockey Woods ZIP 12508
E. IS RESIOENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES '!"J NO
01 / 10 /1984
MONTH DAY YEAR
3. A. AGE 24
3B. DATE OF BIRTH
4. EMPLOYMENT
A. USUAL OCCUPATION Golf Professional
8. TYPE OF INDUSTRY OR BUSINESS Golf
5. PLACE OF BIRTH Danbury, CT
(CITY, STATE / COUNTRY IF NOT USA)
6. FATHER
A. NAME Thomas Andrew Crane, Jr.
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Donna Marie Smith
B. COUNTRY OF BIRTH USA
B. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CNIL ANNULMENT
o 0
DEATH
o
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
(2) 0 DEATH
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
II:
W
'"
::;
::;)
z
o
z
<(
....
UJ
UJ
II:
....
(f)
w
en
z
w
o
:i
~
{ SEAL }
~
NAME (PRINT)
29. OFFICIANT
NAME (PRINT)
SIGNATURE~
DOH.98 (03/2006)
I
STATE FILE NUMBER
(THIS SPACE FOR STA TE USE ONL Y)
I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Breanna Ruth Stilwell
~
11. A. FULL NAME
FIRST
CURRENT SURNAME
MIDDLE
B. BIRTH NAME (MAIDEN NAME). IF DIFFERENT
C. SURNAME AFTER MARRIAGE Crane
(OPTIONAL. SEE REVERSE) 080-78-71 09
D, SOCIAL SECURITY NUMBER
12 RESIDENCE A. NY . B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY 1!1 TOWN 0 VILLAGE
~~~CIFY Fishkill
D STREET ADDRESS 14B South Lockey Woods
ZIP 12508
DYES~NO
A985
YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE?
13. A. AGE 22 38. DATE OF BIRTH 11 /01
MONTH DAY
14. EMPLOYMENT
A. USUAL OCCUPATION Financial Service Rep
B TYPE OF INDUSTRY OR BUSINESS Banking
15. PLACE OF BIRTH PouQhkeepsie, NY
(CITY, STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Richard Brian Stilwell
'B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME Susan SpeedlinQ
B. COUNTRY OF BIRTH USA
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 DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY/COUNTY, STATE/COUNTRY. IF NOT USA) SELF SPOUSE
o 0
o 0
o 0
o 0
al impediment exists
DATE
04/02/2008
by New York Domestic
TIME
MONTH
25. B. SOLEMNIZATION PERIOD
ENDS AT MIDNIGHT ON,
YEAR
MONTH
DAY
YEAR
04
03
01 2008
2008
06
2B. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK 8. COUNTY ~1.~E'56
C, LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF 1i?10WN OF 0 VILLAGE OF
SPECIFY EI/Sf 115J1JdI.l
31.
NAME (PRINT)
SIGNATURE~