036
1ST 0 0 1\ST 0 0
2ND 0 0 2ND 0 0
3RD 0 0 3RD 0 0
~. 0 0 ~ 0 0
I duly swear/affirm, dep'0S8 and say, that to the best of my knowledge and belief that the information I provided is true and that I declare that no legal Impediment exists
as to my right to enter into the ma a estate. ./
21. SIGNATURE OF GROOM~ .,. r RE 22. SIGNATURE OF BRIDE~~ ~ L ~)
23. SUBSCRIBED AND SWORN TO/AFARMED BEFORE ME ~5/12/2007
SIGNATURE OF TOWN OR CIlY CLERK ~ DATE
This license authorizes the marriage in New Yo tate of the bride and groom named above by any person authorized by New York Domestic
Relations Law ~11 to perform marriage ceremonies witH 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 CITYJC RK C M t 25: A. SOLEMNIZATION PERIOD BEGINS
} NAME (PRINT) n. as erson
{SEAL SIGNATURE ~ DATE 05/12/200 YEAR MONTH
'-v-I MAI~ 1OO80fe appinger Falls, NY 12590 2007 07 11 2007
STREET CITYITOWN STATE ZIP
I CERTIFY THAT I SOLEMNIZED 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
:~SM~~:~~~B'b"VJH~ PitfE TIME M . Y YEAR o~ RELIGIOUS
DATE AND AT THE TIME AND
PLACE INDICATED. ~ ()() t1 0 7 9 0 OTHER, SPECIFY
~~~l~~~~ C4~yr r; ~.e;...y: 't!?1/fI.... TITLE !f?~t/", I
SIGNATURE~ ~ ~ DATE ~,N"C- /tf" C/7
MAILING ADD~S ''/ / / ","'
7& ,./~/r/AJ~4 ~/Tt? :;Allt!'/ r// It!-r./I
STREET CITYrrOWN STATE ZIP
:':=?~6~~ '::;:00"_
SIGNATURE~ ~~
DOH-98 (0312006)
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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Christooher William Salmon
FIRST MIDDLE CURRENT SURNAME
COUNTY Dutchess
CITYrrOWN Wappinger
~~~:~c: 1368 .
~5~~~R 36
1. A. FULL NAME
a.
N
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE) 121 72 4443
D. SOCIAL SECURITY NUMBER --
2. RESIDENCEA. Marvland B. Baltimore
(ST~ (COUNTY)
C. CHECK ONE 1!I CITY 0 TOWN 0 VilLAGE
~~CIFY Baltimore
D. STREET ADDRESS 1725 Patapsco Street ZIP 21230
E. IS RESIDENCE WITHIN LIMITS OF CrrY OR INCORPORAlED VILlAGE? r1 YES 0 NO
3. A. AGE 23 3B. DATE OF BiRTH 09 / 1 0 / 198
MONTH DAY YEAR
4. EMPLOYMENT
A. USUAL OCCUPATION Carpentry
B. TYPE OF INDUSTRY OR BUSINESS Construction
5. PLACEOFBIRTH Riverhead, New York
(CITY, STATE I COUNTRY IF NOT USA)
6. FATHER
A. NAME William Frank Salmon
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Lori Ellen Harris
B. COUNTRY OF BIRTH USA
8. NUMBER OF THIS MARF,lIAGE 1
9. ~~~~~~~R~R~h~Bus 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?
(2) 0 DEATt1
(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) (CITYICOUNTY, STATElCOUNTRY, IF NOT USA) SELF SPOUSE
w
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STATE FILE NUMBER
(THIS SPACE FOR STA TE USE ONL Y)
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Lisa Nicole Rosenberger
MIDDLE CURRENT SURNAME
~
11. A. FULL NAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C.. SURNAME AFTER MARRIAGE Salmon
(OPTIONAL- SEE REVERSE) 101-76-0898
D. SOCIAL SECURrrY NUMBER
12. RESIDENCE A. Marvland B. Baltimore
(STA!5I (COUNTY)
C. CHECK ONE C!l' CITY 0 TOWN 0 VILLAGE
~~CIFY Baltimore
D. STREET ADDRESS 1725 Patapsco Street ZIP 21230
E. IS RESIDENCE WITHIN LIMITS OF CrrY OR INCORPORATED VILlAGE? ~ YES 0 NO
05 /17 /1984
DAY YEAR
13. A. AGE 22
3B. DATE OF BIRTH
MONTH
14. EMPLOYMENT
A. USUAL OCCUPATION IT Auditor
B. TYPE OF INDUSTRY OR BUSINESS Accounting
15. PLACE OF BIRTH Buffalo, New York
(CITY, STATE I COUNTRY IF NOT USA)
16. FATHER
A. NAME Joseph Howard Rosenberger
'B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME Pamela Sue Dille
B. COUNTRY OF BIRTH USA
1
18. NUMBER OF THIS MARRIAGE
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIV8RCE CIVIL A"i'(YLMENT
D~H
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
(3) 0 ANNULMENT (2) 0 DEATH
/ /
,-- YEAR
YEAR
10 CIVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEWYORK B.cou~;c4~
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF 0 TOWN OF ~ VilLAGE OF
SPECIFYA~...~/./ ^/h