076
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
oy Oc'" .' 'NT '(,107 MARRIAGE
lJ II luln
FROM THE GROOM
FIRST RiCh~~l5t:EStp,phAn I~URNAME
COUNTY Dutchess
CITYrr~WN Wappinger
~~ ~~~:~~ 1368 '
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1, A. FUU NAME
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
D. ~:~~~:~~~~~RSEh53_64_0937
2. RESIDENCE A. NI=W YORK B. nlltr.hA$~
~E) (cl5utli'Yi
O C. CHECK ONE 0 CITY 0 TOWNol] VILLAGE
~CIFY W;:!ppingers F;:!lIs
D. STREET ADDRESS 10 Trabucco Place ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CIlY OR INCORPORATED VILLAGE? ~ YES 0 NO
01 / 10 / 1 QAO
iiONi'H DAY YEAR
.;.1'\. AGE27 38. DATE OF BiRTH
1\" 'IMPLOYMENT
A. USUAL OCCUPATION Mer.h;:!nic
B. TYPE OF INDUSTRY OR BUSINESS Automotive
5. PLACE OF BIRTH Queens. New York
(CITY, STATE I COUNTRY IF NOT USA)
6. FATHER
A. NAME Stephen Edward Turbe
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Nancy Andrews
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
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
10. 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
I
STATE FILE NUMBER
(THIS SPACE FOR STA TE USE ONL Y)
I
~;P:::N~~~::Ei'i/;Z72~ ~
FROM THE BRIDE
r.hri~tin;:! Marie I IIsh
MIDDLE CUR~NT SURNAME
11. A. FULL NAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE TllrhA
(OPTIONAL - SEE REVERSE)
D. SOCIAL SECURIlY NUMBER 064-74-5863
12. RESIDENCE A NAW Y nrk B.nlltchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY 0 TOWN otJ VILLAGE
~~~CIFYWappingers Falls
D. STREET ADDRESS 10 Trabucco Place ZIP 12590
E. IS RESIDENCE WITHIN UMITS OF CIlY OR INCORPORATED VILLAGE? ~ YES 0 NO
,.19 14A2
DAY YEAR
13. A. AGE ?5
01
MONTH
3B. DATE OF BIRTH
14. EMPLOYMENT
A. USUAL OCCUPATION Administrative Assistant
B. TYPE OF INDUSTRY OR BUSINESS Construction
15. PLACE OF BIRTHCarmAI. New York
(CITY, STATE I COUNTRY IF NOT USA)
16. FATHER
A. NAME William Patrick Lush
'B. COUNTRY OF BIRTt-lJ S A
17. MOTHER
A. MAIDEN NAME Judith McDonouQh
B. COUNTRY OF BIRTJJ S A
18. NUMBER OF THIS MARRIAGE 1
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
DEATH
o
(3) 0 ANNULMENT (2) 0 DEAlli
/ /
- YEAR
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
MONTH DAY
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) (CITYICOUNTY, STATElCOUNTRY, IF NOT USA) SELF SPOUSE
1ST 0 0 1ST
2ND 0 0 2ND
3RD 0 0 3RD
4TH 0 0 4TH
I duly swear/affirm, oeP.0S8 and sa~1 that to the best of my knowledge and belief that the information I provided is tru
as 10 my right to enter into the marnage st
21. SIGNATURE OF GROOM~ 22. SIGNATURE OF BRIDE~
USE RRE
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK.
This license authorizes the marriage in New. Y Slate of th bride and groom named above by any person authorized
Relations Law ~11 to perform marriage ceremonies within New York Slate. THIS LICENSE VALID IN NEW YORK STATE ONLY.
o If checked, this license is to be used onl for the u se of a second or subs uent ceremon .
~ 24. TOWN OR CITY LER'C M 25. A. SOLEMNIZATION PERIOD BEGINS
} NAME (PRINT) J .
{SEAL SIGNATURE ~ DATE 07/25/2007 TIME YEAR
"-v-I M~~1OO~ appinger Falls, NY 12590 06:24:~ 07 26 2007
STREET CITYIT STATE ZIP
~~~R~:RT':~ 'O~~~N:.z:~ 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
SONS NAMED ABOVE ON THE TI Y R 0 D~E IGIOUS 1 0 CIVIL
DATE AND AT THE TIME AND
PLACE INDICATED. 9 THER, SPECI
o 0
o 0
o 0
o 0
legal impedlmenl exists
by New York Domestic
MONTH
YEAR
09
23 2007
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY U \~~
C. LOCATION OF CEREMONY ~r1
(CHECK ONE AND SPECIFY) ~ _ r:lirJ!!:>
o CITY OF V1'bWN OF.. 0 V LAGE OF r*
"'-d~., ~tLthuf ~OI
SPECIFY '-:>\~.
J.4. '"0" Fad" \;~ n It €:.-J
~
i
@['~~fM'&~-J~
141 Valley Farm Road
Millbrook, New York 12545
845-231-2428
August 27, 2008
To: John Masterson, Town Clerk
Wappinger, NY
Re: Richard Stephen Turbe
Christina Marie Lush
In regards to the above couple: I did not receive your memo that would have prevented
my error in regards to "block #28" on their marriage license. Thus, I had no way of
knowing that I should have entered "Town ofWawarsing" instead of the town of
Kerhonkson.
I am writing to inform you that I, Reverend Sara Henderson-Ingeman, joined Richard
Stephen Turbe & Christina Marie Lush in marriage at: The Hudson Valley Resort & Spa
at 400 Granite Road in Kerhonkson,; or, as yOU state, is the "correct name for this location:,
"Warwarsing," NY 12446 on August 11,2007.
I will inform Richard & Christina of this impediment in having you initially process their
license and forward all documents to them so that they can signature and have certified,
your DOH-1827 form. I am enclosing with this letter a certified copy of my clergy
records as you have requested.
enderson-Ingeman
II~IISTATE OF NEW YORK
W DEPARTMENT OF HEALTH
Corning Tower
The Governor Nelson A. Rockefeller Empire State Plaza
Albany, New York 12237
September 14, 2007
Groom:
Bride:
Richard Stephen Turbe
Christina Marie Lush
Dear Town/City Clerk:
Enclosed is a copy of the marriage referred to by the above file in your office.
Correction to the original has been made based on:
o Affidavit
IZI Officiant's Statement
o Signature on original marriage affidavit
o Statement verified by City/Town Clerk
o Other: Supplemental
Please file this amended record along with the supporting documentation.
If you have any questions, please call us at (518) 486-3301.
Sincerely,
~~
Arleen Meres
New York State Dept. of Health
Vital Records Section
Marriage Registration Unit
P.O. Box 2602
Albany, NY 12220-2602
Enclosure
TOWN OF WAPPINGER
TOWN CLERK
CHRIS MASTERSON
SUPERVISOR
JOSEPH RUGGIERO
TOWN CLERK'S OFFICE
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
(845) 297-5771
FAX: (845) 298-1478
TOWN COUNCIL
WILLIAM H. BEALE
VINCENT BETTINA
MAUREEN McCARTHY
JOSEPH P. PAOLONI
Rev. Sara Henderson-Ingeman
141 Valley Fann Road
Millbrook, NY 12545
Dear Rev. Sara Henderson-Ingeman,
My office has received the Marriage License for the marriage of Richard Stephen Turbe and
Christina Marie Lush, which you performed on August 11 th, 2007. At the time of licensing,
my office provided the couple with a memo that would assist you in the completion of block
#28. The information that you entered into block #28 is incorrect. There is no Town of
Kerhonkson. The entry should have read "Town ofWawarsing".
I am enclosing a DOH-1827: Affidavit for Correction of Marriage License. The affidavit
"must be signed by both the husband and wife in the presence of a notary public".
Documentation is also required to make corrections to the Marriage License. In this case,
sufficient documentation is:
. a letter from the officiant, on official letterhead, or
. a certified copy of the officiant's record, or
. a Church Certificate with seal
Please mail the affidavit and documentation to my office at your earliest convenience.
cc: Richard Stephen Turbe
Christina Marie Lush
Enc.
STATE OF ~JO\.u '-\O\\L..
Affid avit for
Correction of Marriage Record
FOR OFFICIAL NYS USE ONLY
NEWYORK STATE DEPARTMENT OF HEALTH
Vital Records Section
} ss:
State File #
Groom:
Bride:
Date Completed:
and O~(,,\'S.-\;.l'\a 1-0"&"'-
(Bride/Maiden Name)
COUNTY OF
We,
~\&\CL(' c\ """\"I1..rV\<1
(Groom)
being severally sworn, depose and say that:
1 . We reside at: (0 TfC\.'o\.AC.<'O P fS "\S-
( tr et ress)
2. Marriage License issued by CityfTown: ~ \tJO-~~\ ~~
3. Date of Marriage: ~ ~ tc+ \\ I f=))(:('),
4. Error(s) appearing on record (list exactly):
a.
\()\Gc...~ ~ a~
ToL))Yl ~ \~.o.rroV'\\-4.~V""')
b.
c.
5. Correct information as it should appear (list exactly):
a. ~ I. D <\ 09 '^ \D--\AXl.rs '\ ~
b.
c.
6. Documentation Submitted:
a.
\...~-\\-Qc ~ ~~ido..v\ \- ~ l.-.a.-~\t\.sLo...d.
Qp,~ 9;.d,a.... (\-~l ~ 66 ~'c' Lo...V\~<.... "..occ-rc\
b.
c.
This affidavit with supporting documentation is being made for the purpose of having the record of marriage show the
true facts and this affidavit will become a permanent record. The marriage record is filed with the State of New York.
~~~~
s({n'M H~Sb~and ~
~ ~c-~,L
Signature of Wife
dayo! t2.ugU( r-l-
Notary Public YZ/tff8-l?l()A /Gu ;f
NOTE: Certificate of Authenticity required for notary public outside New York State
Subscribed and sworn to 'l o.f/L.
(affirmed) before me this 0/ 0
, rO()O 1-
JANET E. MARKERT
-Nota"PlSbllc . State nt He. 'f....
Na.01MA5117742
'Qualified to Putnam CoulltY.
:Com~. Ell Hes NOll.] 20Q8
n(")I-l_1 ~~7 {nc;/~nn4\
(over)
o
(fJ(~(t/U#O/~-f~
141 Valley Farm Road
Millbrook, New York 12545
845-231-2428
August 27, 2008
To: John Masterson, Town Clerk
Wappinger, NY
Re: Richard Stephen Turbe
Christina Marie Lush
In regards to the above couple: I did not receive your memo that would have prevented
my error in regards to "block #28" on their marriage license. Thus, I had no way of
knowing that I should have entered "Town ofWawarsing" instead of the town of
Kerhonkson.
I am writing to inform you that I, Reverend Sara Henderson-Ingeman, joined Richard
Stephen Turbe & Christina Marie Lush in marriage at: The Hudson Valley Resort & Spa
at 400 Granite Road in Kerhonkson,; or, as you state, is the "correct name for this location:,
"Warwarsing," NY 12446 on August 11,2007.
I will inform Richard & Christina of this impediment in having you initially process their
license and forward all documents to them so that they can signature and have certified,
your DOH-1827 form. I am enclosing with this letter a certified copy of my clergy
records as you have requested.