171
+
....
z
w
Ul
W
III
:I
::l
o
:I:
Ul
Z
o
~
Ul
a
w
a:
w
~
a:
a:
~
u.
o
~
o
u:
~
W
o
W
a:
W
~
Ul
Ul
W
a:
o
o
<
it
u
W
0-
Ul
w
en
z
w
0
::i
+
~~~ W
~1f~ ~
a:"'rs
~~~ 0
::lOW
:::;(!l6 i!
!!~Ul i=
~~~ a:
H:OCl> w
0....> 0
..w~
t!ffi~
!i3~
COUNTY Dutchess
CITYn-OWN WappinQer
~~~:~ 1368 '
~5~I~R 171
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Mustafa Lokmaci
MIDDLE CURRENT SURNAME
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
"I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Ka~D'Xr Sara Pactr~~~ SURNAME
~
1. A. FUll. NAME
11. A. FUll. NAME
FIRST
FIRST
0-
N
B. BIRTH NAME, IF DIFFERENT
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE) 128 60 0209
D. SOCIAL SECURITY NUMBER --
12. RESIDENCE A. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY rY TOWN 0 VilLAGE
~~~CIFY Fishkill
D. STREET ADDRESS 8 Greenhill Drive ZIP 12524
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES ri NO
13. A. AGE 30 3B. DATE OF BIRTH 08 /08 /1976
MONTH DAY YEAR
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE)
o SOCIAL SECURITY NUMBER 087 -90-3806
2. RESIDENCE A. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY [ljI( TOWN 0 VilLAGE
~~~CIFY Fishkill
D. STREET ADDRESS 8 Greenhill Drive
ZIP 12524
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES r::! NO
12 / 15 / 1973
MONTH DAY YEAR
3. A. AGE ~?
3B. DATE OF BiRTH
l-
S;
<C
~ c
i!
LL
<C
4. EMPLOYMENT
A. USUAL OCCUPATION Public Relations
B. TYPE OF INDUSTRY OR BUSINESS Unemployed
5. PLACE OF BIRTH Istanbul. Turkey
(CITY, STATE / COUNTRY IF NOT USA)
6. FATHER
A. NAME Ahmet Lokmaci
B. COUNTRY OF BIRTH Turkey
7. MOTHER
A. MAIDEN NAME Emine Unver
B. COUNTRY OF BIRTH Turkey
B. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
o 0
14. EMPLOYMENT
A. USUAL OCCUPATION Teacher
B. TYPE OF INDUSTRY OR BUSINESS Beacon City Schools
15. PLACE OF BIRTH Niskayuna, New York
(CITY. STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Richard Thomas Patrick
'B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME Sharon L. Pierce
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
DEATH
o
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
(2) 0 DEATH
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) (CITY/COUNTY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
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, STATEICOUNTRY, IF NOT USA) SELF SPOUSE
(3) 0 ANNULMENT (2) 0 DEATH
/ /
.'- YEAR
(3) 0 ANNULMENT
/ /
::l
Z
Q
~
Iii
w
~
1ST 0 0 1ST 0 0
2ND 0 0 2ND 0 0
3RD 0 0 3RD 0 0
~ 0 0 ~ 0 0
I duly swear/affirm, dep.ose 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 m age state. ~
21. SIGNATURE OF GROOM~V 22. SIGNATURE OF BRIDE~ 9<;ttthJ,.<A'Y\ ~ "C.'.1r
USE CURR . ~RRENT N
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME 10/25/2006
SIGNATURE OF TOWN OR CITY CLERK ~ DATE
This license authorizes the marriage in New York State of the bride and groom named above by any person authorized by New York Domestic
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.
_ r-I'-.. 24. TOWN OR CITY CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
{ } NAME (PRINT) John C. Masterson
TIME MONTH YEAR MONTH
SEAL SIGNATURE ~
'-v-' MAI~B 'lOO~d AM 10
STREET 04:4Q>M
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICATED.
YEAR
26
2006
24 2006
12
28. PLACE WHERE MARRIAGE OCCURRED
1 DC CIVIL
A. STATE NEW YORK B. couw&'lff-+Oro....
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF . TOWN OF 0 VILLAGE OF
SPECIFY C 1,1"f-1) N Ht1l?k
SIGNATURE~
DOH-98 (0312006)
NOFUS .
Servj IDAlU;
Stand ce de l'etat ~j.
eslllntsb C1Vll d
eh6rde e
I
~-
i
i
I
I
S I
:A.RX"""
....c.,R/. ,
XSTA.<
'0
No:
1974
-000158
tSTANBur,
)027
-
'5
e
~
4.l
~
""""~
~j:
~:!
~:a
~ .C
~:
\C
0\
'1""1
i
I
i
i
i
I
I
--L
~
1-0
.D
o
.....
o
~o
~.g
~~
E::~
~~
~j
~ ~
"'0
=
o
.-
/'""0.
......
I.{)
0\
......
NM-.i
~
~
f-,;
~
~
. .
. .
: . :...: j., 1;'
. ~. .t
. .7. .,.
. t/ . ~. a
:~ . .\ V> ,..;---.,
{.I. ~ ~~r, y.-:.,.-:~-:::-.;. .1'
~-: ;"t \l~ ',,'1
. .rl\' - \ ~/' ::~~:'
.\ ": . ;,\..-", ' "
~" ':. ,_/ ,r..;...,',,}
.' ~ ~ A"' J
~'....~t;'C. 00. .;,'~'
-:. \. '1\,. <:::;J-i
,t'J: '" .....-:e./'."
(1'- ""~ .. .",,-"
V)~~ ~ ,3
. ..c
. : : 0 1:3
: : :z ~
V'\'-Or-:oOo'
\-;J-
L-_
DEVLET TURKivE CUlYlHURiVETi
Etat
Staat
~J
NUFUS iDARESi
Service de l'etat civil de
Standesarn~beh6rde
FORMUL A
SARIYER/iSTANBUL
.......,
..~
'-
'-
\
\
[~J
DOGUM KAVlT ORNEGi
Extrait de l'acte de naissance
Auszug aus dem Gebumeintrag
No: 1974-000158
4
DOGUM TARiHi VE VERi
Date et lieu de naissance
Tag und Ort der Geburt
iSTANBUL
SOY ADI
5 Nom LOKMACI
Name
ADI
6 Prenoms MUSTAFA
V ornarnen
KiMLiK NO
13 Numero d'identification 27565729306
I Personenkennzeichen
r- I
I CiNSivETi 0 BABA
7 \ Sexe M Pere
Geschlecht Vater
I
SOVADI LOKMACI
5 Nom
Name
ANA
I;l Mere
LI Mutter
LOKMACI
6
ADI
Prenoms
V ornarnen
AHMET
EMlNE
12
NUFUSTA KA YlTLl OLDUGU YER *
Lieu et numero du registre de famille
Ort und Nummer des Familienregisters
ALUCRA
1133-0025-00001-0027
10 I
------l
iSLEME AiT DiGER BiLGiLER
Autres enonciations de I'acte
Andere Angaben aus dem Eintrag
11
YERiLiS TARiHi
Date de delivrance
Tag der Ausstellung
iMZA
Signature
Unterschrift
M. ZEKl
\j.H.K.1
~SYMBOLES/ZEICHEN/SYMBOLS/SiMBOLOS/LYMBOAAlSIMBOLIISYMBOLEN/SiMBOLOS!i~ARETLERlSIMBOLl
-Jo : Jour I Tag! Day IDla I'HJ.lepa! Glomo! Dag! Dia I GUn I Dan
-Mo: Mois I Monat I Month I Mes! M~v I Mese I Maand ! Mes! Ay ! Mesec
.An: Annee! Jahr I Year IAno I'ElO<; I Anno! Jaar I Ano! YII! Godina
-M : Masculin! Mannlich I Masculine I Masculino I AppEV I Maschil~ I Mannelijk I Masculino! Erkek I Mu~ki
-F: Feminin I Weiblich I Feminine! FemeninllJ0ilJ.u I Femminile! Vrouwejijk I Feminino! Kadml Zenski
.Mar: Mariage / Eheschlieflung I Marriage I Milirimonio I fliJ.lo<; I Matrimonio! Huwelijk I Casamento I Evlenme / Zaklju~enje braka
-Sc: Separation de corps I Trennung van Tisch und Bett I Legal separation I Separaci6n de cuerpos I XOlploJ.l6<; Cl1t6 tpCl1tt~ll<; KClI Koit1l<; I Separazione
personale I Scheiding van tafel en bed I Separa~llo de pessoas e bens I Aynhk I Fizi~ka rastava
-Div: Divorce! Scheidung I Divorce I Divorcio I AlCl~6yIOV I Divorzio I Echtscheiding I Div6rcio I Bo~anma I Razvod
.A :Annulation I Nichtigerklarung I Annulment IAnulaci6n / AK6pOlot<; / Annullamento I Nietigverklaring I Anul~iio I tptall Poni~tenje
-Om: Oeces du mari I Tod des Ehemannes I Death of the husband I Defunci6n del marido I 0liVCltO<; toil ou~6you I Morte del marilo I Overlijden van de man
I Obito do marido! Kocanm olilmU I Smrt mula
.Of: Oeces de la femme! Tod der Ehefrau ! Death of the wife! Defunici6n de la mujer ! 0avata<; TI'\<; ou~6yo\J I Morte della moglie ! Overlijden van de
vrouw! Obito da mulher / Kannm alUmU ! Smrt Zene
'II a ete ajoute par la decision du 10.9.1987 de I' Assemblee Generale de erne a Lisbonne
EXTRAIT DELIVRE EN APPLICATION DE LA CONVENTION SIGNEE A VIENNE LE 8 SEPTEMBRE 1976*
AUSZUG AUSGESTELL T GEMASS DEM UBEREINKOMMEN VON WIEN VOM 8 SEPTEMBER 1976
EXTRACT ISSUED IN PURSUANCE OF THE CONVENTION SIGNED AT VIENNA ON SEPTEMBER 8,1976
CER TIFICACION EXPEDIDA EN APLICACION DEL CONVENIO FIRMADO EN VIENA EL 8 DE SEPTIEMBRE DE 1976
ATIOI:ITAI:MA XOPHrorMENoN KAT E<I>APMOrTIN THI: ErMBAI:EnI: TIlI: BIENNHI: THI: 8 I:EHTEMBPIor 1976
ESTRATTO RILASCIATO IN APPLICAZIONE DELLA CONVENZIONE FIRMATA A VIENNA IL 8 SETTEMBRE 1976
UITTREKSEL AFGEGEVEN INGEVOLGE DE OVEREENKOMST ONDERTEKEND TE WENEN OP 8 SEPTEMBER 1976
CERTIDAO EMITIDA AO ABRIGO DA CONVENc;AO ASSINADA EM VlENA AOS 8 DE SETEMBRO DE 1976
viY ANA'DA 8 EYLUL 1976 TARiHiNDE iMZALANAN SOZLE~ME UY ARINCA YERiLEN ORNEK
IZVOD IZDAT NA OSNOVU PRIMENE KONVENCIJE POTPISANE U BECU 8 SEPTEMBRA 1976
1 Staat/Country /Estado/Kpa.oqStato/S taat/EstadolDev let/Drzava
2 Standesamtsbehorde/Civil registry office otIRegistro civil del ATj~lUpxudl apxf1.ou/Servizio dello state civileIDienst van
de burgerlijke stand van/Serviyos do registo civil de/Niifus idaresiIMaticna sluzba
Auszug aus dem Geburtseintrag NrlExtract from birth registn;tion no./Certificacion del acta de nacimiento
3 no./AnoO"1ta~f.lu A.l1~taPXl1(ijs npa~ecos yaf.lou apto.{Estratto dell'atto. di nascita n./Uittreksel uit de geboorteakte
nr./Certidao do asscnto dc nascimento nolDogum kavlt 5megi No/lzvod iz maticne kniige rodienih br.
4 Tag und Ort der GeburtIDate and place of birth/Fecha y lugar de nacimiento/XpovOA.oyta xui. 't61toS 'teMaeco<; 'WuIData e
luogo di nascitalGeboortedatum en plaatslDate e lugar do nascimentolDogum tarihi ve yeriIDatum i mesto rodjenja
5 N ame/N ame/ Apellidos/Emilwf.lov/CognomelN aam! Apelidos/Soyadl/Prezime
6 V omamen/F orenameslN ombre propio/Ovollu'taIPrenomiN oomamenINome proprio/ AdllIme
7 Geschlecht/Sex/S exo/<I>uA.OV / sesso/Ges lach t/Sexo/Cinsiyeti/Pol
8 V ater/F ather lPadre/IIu'tij p/PadreN ader/Pai/BabalOtac
9 MutterIMotherlMadre/Mij'tTjplMadre/Moeder/Mael Ana/Majka .;.,...
Andere Angaben aus dem Eintrag/Other particulars of the registrationfOtros datos del actal"E'tepm tyypu<pui -ci]s
10 npa~EcoqAltre enunciazioni dell'atto/Andere vermeldingen van de akte/Outros elementos do assento/I~leme ait diger
bilgilcrlDrugi podaCl iz izvoda
Tag der Ausstellung, Unterschrift, SiegelIDate of issue, signature, seal/Fecha de expedicion, firm a, sellolXpovoA.oyiCl.
11 8KMaEco<;, iinoypCl.<piJ, G<ppayiqoata di rilascio, firma, bollolDatum van afgifte, handtekening, zegelIData de emissao,
assinature, seloNerilis tarihi, imza, miihiirIDatum izdavania, potpis, pecat
Ort und Nummer des FamilienregisterslLocation and number of the family registerlLugar y numero del registro de
12 familialTorws Kai apt6f.los 'tou oi.KoyevetaKOU IlTj'tpcboulLuogo e numero del registro di famiglia/Plaats en nummer van
het familieregister/Lugar e numero do registro de familialNUfusta kavltlt oldugu ver/Mesto i broi upisa u mati<;ne kniige
13 PersonenkclU1Zcichen/Identification numberlNumero de identificationlI1poaoWptG't1KOS apt6f.l6s 'tOU a:t6f.lou/Numero di
identificazione/ldentificatienummerlNumero de identificayao/Kimlik No/Broj lione karte
*Bu slizle~meIlin 3,4,5 ve 7'nei maddelerine glire:
KaYltlar Latin kitap harfleri ile yazlhr; bu kaYltlar aynca, dayandlklarl belgenin dilzenlenmesinde kullanllan dilin harfleri ile de
yazllabilir.
Tarihler, SJraslyla gUn, ay ve Yllt gosteren rakamlarla yazdlr. GUn ve ay iki rakamla, Yll d5rt rakamla g5sterilir. Aym ilk dokm
gUnii ve yIlm ilk dokuz aYI 01 'den 09'a kadar olan rakamlarla g5sterilir.
Her yer isminin yamna, eger bu yer omegi veren devletin Ulkesinde degil ise, bu yerin bagh oldugu devletin adl da yazlltr.
Mar, Sc, Diy, A, D, Dm, Df i~arctlerini, olay tarihi ve yeri izler aynca, Mar i~aretinden sonra e~in soyadl ve adl yazlhr.
Belgedeki aylklamalar, bir haneyi yeya bu hanenin bir klsmlm doldurmaya imkan vermedigi takdirde, bo~ kalan klslm yizgilerle
kullamlmaz hale getirilir.
Diger hane yeva isaretlerin eklenmesi. 5nceden Milletlerarasl Ahvali Sahsive Komisyonunun onayma sunulur.