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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
F('~~Di.~n!=:Aph VcmlNTSURNAME
US
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New' Y k State of the bride and groom named above by any rson authorized
Relations Law ~11 to perform marriage ceremonies In New York State. THIS LICENSE VALID IN NEW YORK STATE ONLY.
o If cheeked, this license is to be used only for the purpose of a second or subsequent ceremon .
~ 24. TOWN OR CITY CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
} NAME (PRINT) John C. Mast son
{ SEAL SIGNATURE~ . _ DATE 08/01/2007 TIME MONTH YEAR
'-.-J MA~rr~crBf~ appinger Falls, NY 12590 AM 08 02 2007
-yo- 05:38 PM
STREET CITYITOWN STATE ZIP
I CERTIFY THAT I SOLEMNIZED 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
~~~~~- ~
SONS NAMED ABOVE ON THE TIME MO. AY YEAR 0 0 RELIGIOUS 1 CIVIL
DATE AND AT THE TIME AND ...
PLACE INDICATED. 6/ d:) PM 9 0 OTHER, SPECIFY
COUNTY Dutchess
CITYfTOWN Wappinger
~~~~~ 1368 .
~5~1:~~R 81
1.. A. FULl.NAME
FIRST
Q.
N
B. BIRTH NAME. IF DIFFERENT
C. SURNAME AFTER MARRIAGE
D. ~:':~~~~U~B:RSE)080-66-1230 .
2. RESIDENCE A. NY B. nlltr.hA~~
(STATE) (COUNTY)
C. CHECK ONE 0 CITY o,l] TOWN 0 VILLAGE
~~CIFY Unionvale
D. STREET ADDRESS 6 Jordan Ct ZIP 12570
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VIlLAGE? 0 YES ~ NO
3. A. AGE A.1' 3B. DATE OF BiRTH n~ /?~ / 1 ~66
MONTH DAY YEAR
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4. EMPLOYMENT
A. USUAL OCCUPATION Plumber
B. TYPE OF INDUSTRY OR BUSINESS Plumbina
5. PLACE OF BIRTH Manhattan. NY
(CITY. STATE / COUNTRY IF NOT USA)
6. FATHER
A. NAME George William Vogel
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Carol Ann McAloon
B. COUNTRY OF BIRTH USA
8. NUMBER OF THIS MARRIAGE 2
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
B. HOW DID LAST MARRIAGE END? (3) M DIVORCE (3) 0 ANNULMENT
c. DATE LAST MARRIAGE ENDED? 07 / 16 /
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? &'YES 0 NO
10. IF PREVIOUSLY DIVORCED OR ANNULLED. PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH. DAY, YEAR) (CITYICOUNTY. STATEICOUNTRY, IF NOT USA) SELF SPOUSE
07/16/2007 Poughkeepsie, NY M
DEATH
o
(2) 0 DEATH
2007
YEAR
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1ST
2ND
3RD
4TH
I duly swear/affirm, dep.ose and say
as to my right to enter into the m
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21. SIGNATURE OF GROOM
NAME (PRINT)
SIGNATURE~
tlOH-98 (0312006)
I
STATE FILE NUMBER
(TH/S SPACE FOR STATE USE ONL Y)
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
--.J
11. A. FUll. NAME FIRST ~I~ n Ma ri no CURRENT SURNAME
8. BIRTH NAME (MAIDEN NAME), IF DIFFERENT Prinr.ipA
c. SURNAME AFTER MARRIAGE V ogAI
(OPTIONAL' SEE REVERSE)127 60 9911
D. SOCIAL SECURITY NUMBER --
12. RESIDENCE A. NY B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY li1'l TOWN 0 VILLAGE
~~~CIFY Unionvale
D. STREET ADDRESS 6 Jordan Ct
ZIP 12570
o YES~ NO
A'969
YEAR
E. IS RESIDENCE WITHIN IJMITS OF CITY OR INCORPORATED VIlLAGE?
13. A. AGE 37 3B. DATE OF BIRTH 12 /27
MONTH DAY
14. EMPLOYMENT
A.' USUAL OCCUPATION T eacher
B. TYPE OF INDUSTRY OR BUSINESS Lakeland School Dist
15. PLACE OF BIRTH Dover. NJ
(CITY. STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Anthony Joseph Principe
'B. COUNTRY OF BIRTHU S A
17. MOTHER
A. MAIDEN NAME Diann Carol Bernard
B. COUNTRY OF BIRTHU S A
18. NUMBER OF THIS MARRIAGE 2
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
B. HOW DID LAST MARRIAGE END? (3) d DIVORCE (3) 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? 07 / 22 / 2004
MONT!U DAY"- YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? L:J YES 0 NO
...
20. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITYICOUNTY, STATElCOUNTRY,IF NOT USA) SELF SPOUSE
1ST 07/22/2004 Poughkeepsie, NY ~
2ND 0
3RD 0
4TH
at the information I provided is rue and that I deela
DEATH
o
22. SIGNATURE OF BRIDE
ATE
by New York Domestic
MONTH
YEAR
09
30 2007
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY D~
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
ft{. CITY OF 0 TOWN OF 0 VILLAGE OF
SPECIFY pf)~k~S/~
NAME (PRINT)
SIGNATURE~