037
,
SECU
23. SUBSCRIBED AND SWORN T AFFIRMED BEFO ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New Y r State of e bride and groom named above by any person authorized by New York Domestic
Relations Law ~11 to perform marriage ceremonies wit in New York State. THIS LICENSE VALlb 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 CITYJC RK C M t 25. A. SOLEMNIZATION PERIOD BEGINS
} NAME (PRINT) . as erson
{SEAL SIGNATURE ~ DATE 05/16/200 TIME MONTH YEAR MONTH
"-- -.J MAI~ Wmfdfi appinger Falls, NY 12590 ,.f.M 05 17 2007 07 15 2007
-v- 04:4"PM
STREET CITYITOWN STATE ZIP
~~~R~~Ri~~~ lo~O~~~N:.zi~ 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY /
SONS NAMED ABOVE ON THE TIME M. DAY YEAR 00 RELIGIOUS 1 ClYCIVIL
DATE AND AT THE TIME AND .a,.t:>
PLACE INDICATED. ~ 9 0 OTHER, SPECIFY
+
~
W
o
W
III
C
...J
=>
o
:r
o
z
o
~
o
a
W
a:
W
~
a:
a:
:i
u.
o
W
!;(
t.>
u:
~
W
t.>
W
a:
W
~
o
o
W
a:
c
c
<
Ii:
u
W
l>.
o
z
o
z
<
Iii
W
~
+
~~z W
~~~
a:><~ ~
~~~ (,)
=>t.>W
~ClcS Ii:
~;1!;0 _
~~15 ti:
[00 W
01->
1i.i~C5 (,)
bffi'"
zg;1!;
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
James Joseph Babcock
MIDDLE CURRENT SURNAME
COUNTY Dutchess
CITYfTOWN Wappinger
~~~:~c: 1368
~3~~J~R 37
1. A. FULL NAME
FIRST
0-
N
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE) 095-60-0840
D. SOCIAL SECURITY NUMBER
2. RESIDENCE A. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY I!'f TOWN 0 VILLAGE
~~~CIFY WappinQer
D. STREET ADDRESS 20B Alpine Drive
ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES t1 NO
03 / 14 / 1968
MONTH DAY YEAR
3. A. AGE 39
3B. DATE OF BIRTH
4. EMPLOYMENT
A. USUAL OCCUPATION Heavy Equipment Operator
B. TYPE OF INDUSTRY OR BUSINESS City Of Beacon
5. PLACEOFBIRTH Beacon, New York
(CfTY, STATE / COUNTRY IF NOT USA)
6. FATHER
A. NAME James Edward Babcock
B. COUNTRY OF BIRTH U.s A
7. MOTHER
A. MAIDEN NAME Bernice Hundley
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
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
(2) 0 DEATH
w
en
z
w
(,)
:J
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
I
Lo
11. A. FULL NAME
SUPPLEMENTAL FILE
FROM THE BRIDE
Jeanine Bernadette Geiser
MIDDLE CURRENT SURNAME
~
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Babcock
(OPTIONAL - SEE REVERSE) 115-72-9523
D. SOCIAL SECURITY NUMBER
12 RESIDENCE A. New York 8 Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY r:! TOWN 0 VILLAGE
~~~CIFY WapQin~er
D. STREET ADDRESS 20B Alpine Drive ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES 6 NO
02 /25 /1975
DA" YEAR
13. A. AGE 32
3B. DATE OF BIRTH
MONTH
14. EMPLOYMENT
A. USUAL OCCUPATION Document Analysis
B. TYPE OF INDUSTRY OR BUSINESS Con-Ed
15. PLACE OF BIRTH North Tarrytown, New York
(CITY. STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Martin Geiser
'B. COUNTRY OF BIRTH Germany
17. MOTHER
A. MAIDEN NAME April Rose Troise
B. COUNTRY OF BIRTH USA
1
1 B. NUMBER OF THIS MARRIAGE
19. PREVIOUS MARRIAGES .
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIV8RCE CIVIL AN~LMENT
De.cJH
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT (2) 0 DEATH
/ /
- YEAR
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALI17e'l-- 0 YES 0 NO
to
20. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY/COUNTY, STATiElCOUNTRY, IF NOT USA) SELF SPOUSE
1ST
2ND
3RD
4TH
at the information I provided is tru a
o
o
o
22. SIGNATURE OF BRIDE ~ '/..
YEAR
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY -1)" 7l::J1'SJ
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
29. OFFICIANT
NAME (PRINT)
SIGNATURE ~
MAILING ADDRE~A~
I ('~ Trr::teT
STREET CITYfTOWN
30. WITNESS TO CEREMONY
NAME (PRINT) ~ IJ(2 n t{ea;f+-.e( Ge.-~
~1r.NATlIRF. ~~~~A OA.
o CITY OF
SPECIFY
.....
ZIP
31. WITNESS TO CEREMO~ I:: l' .c 'I)
NAME (PRINT) .,. J;: Q..:,rY f!. 1- LP!!!J,>> I ~}/te,
~1~~IATlln~" l-//.JA ___ L 4/J~-'~\