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COUNTY Dutchess
CITYfTOWN Wappinqer
~~~:f~ 1368 .
~5~I:l~R 150
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Michael Robert Corrao
MIDDLE CURREm SURNAME
FIRST
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
SaraMI~~therine L~u~g~/SURNAME
.-J
1 . A. FUll NAME
11. A. FULL NAME
FIRST
Q..
N
B. BIRTH NAME, IF DIFFEREm
B. BIRTH NAME (MAIDEN NAME). IF DIFFEREm
C. SURNAME AFTER MARRIAGE Corrao
(OPTIONAL - SEE REVERSE) 524-37-6332
D. SOCIAL. SECURITY NUMBER
12. RESIDENCE A. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY rY TOWN 0 VILLAGE
~~~CIFY Wappin~er
D. STREET ADDRESS 115 All Angels Hill Road
C. SURNAME AFTER MARRIAGE
(OPTIONAl - SEE REVERSE)
D. SOCIAL SECURITY NUMBER 081-70-6458
2. RESIDENCE A. New York B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
AND W .
SPECIFY applnqer
D. STREET ADDRESS 115 All Angels Hill Road
12590
ZIP
YES 6 NO
/1982
YEAR
ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILlAGE? 0 YES d" NO
06 / 02 / 1981
MONTH DAY YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILlAGE? 0
06 /02
DAY
13. A. AGE 24
3. A. AGE 25
3B. DATE OF BIRTH
38. DATE OF BIRTH
MONTH
4. EMPLOYMENT
A. USUAL OCCUPATION Cable Technician
B. TYPE OF INDUSTRY OR BUSINESS AWlS Co.
5. PLACE OF BIRTH Cortland, New York
(CITY, STATE I CoumRY IF NOT USA)
6. FATHER
A. NAME Robert Michael Corrao. Jr.
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Kathleen Mar~aret Conklin
B. COUNTRY OF BIRTH USA
8. NUMBER OF THIS MARF,lIAGE 2
14. EMPLOYMENT
A. USUAL OCCUPATION Server
B, TYPE OF INDUSTRY OR BUSINESS Bugaboo Creek
15. PLACE OF BIRTH Denver, Colorado' .
(CITY, STATE I COUmRY IF NOT USA)
16. FATHER
A. NAME Georqe Earl Looper
'B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME Dyanne Lorraine Rash
B. COUNTRY OF BIRTH USA
1 B. NUMBER OF THIS MARRIAGE 2
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES .WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
B. HOW DID LAST MARRIAGE END? (3) ~IVORCE (3) 0 ANNULMENT (2) 0 DEATH B. HOW DID LAST MARRIAGE END? (3) O~IVORCE (3) 0 ANNULMENT (210 DEATH
C. DATE LAST MARRIAGE ENDED? 07/ 12 / 2005' c. DATE LAST MARRIAGE ENDED? 04 / 11 / 20U2
MONTH ., DAY YEAR MomH sI DAY. ,- YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
..
10. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION 20. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY/COUNTY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE (MONTH1 DA~ YEA'3l. ICITY/COUNTY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
07/12/2005Duval Co., Florida 0.,1 0 1ST 04/ 1/,00L Pnoenix, Anzona 0 0"
o 0 2ND 0 0
o 0 ~D 0 0
o 0 4TH 0 0
e best of my knowledge and belief that the information I provided is tr and that I declare that no legal impediment exists
DEATH
o
DEATH
o
1ST
2ND
3RD
4TH
I duly swear/affirm, depose and
as to my right to enter into the
21. SIGNATURE OF GROOM~
09/13/2006
USE CUR
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME
SIGNATURE'OFTOWN 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.
~ 24. TOWN OR CIJCL~RK 25. A. SOLEMNIZATION PERIOD BEGINS
{ SEAL } SNAIGMNEAT(PURRIEN: 0 n "'", YEAR MONTH
... , j DATE 09/13/200
'-v-' MAI~b 'tWffdfeb sh Rd~ Wappinger Falls, NY 12590 2006 11 12 2006
STREET,' STATE ZIP
I CERTIFY THAT I SOLEMNIZED 27. TYPE OF CEREMONY
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE 0 0 RELIGIOUS
DATE AND AT THE TIME AND
PLACE INDICATED. 9 0 OTHER, SPECIFY
YEAR
28. PLACE WHERE MARRIAGE OCCURRED
1 Q!LcIVIL
A. STATE NEW YORK B. COUNTY O\..JtGd6
TITLE r ()a.).v ~~"c.e
9. IS". 2Po v;
C1rlL t ~5i L
STATE
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF ~ TOWN OF 0 VILLAGE OF
SPECIFY E'r. oS f h:S- hILI all
" ,
SIGNATURE~
SIGNATURE~