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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
COUNTvDutcbess
CITYfTowNWappinger
~~~~~c~1368
REGISTE~9
NUMBER
a.
N
1. A. FULL NAME ~pel Caste!~~LE CURRENT SURNAME
B BIRTH NAME, IF DIFFERENT Alexander Del Castello
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE)
D. SDCIAL SECURITY NUMBER 133-66-1403
2 RESIDENCE A NY B. n. d,.hp-~~
(STATE) ~
C. CHECK ONE 0 CITY ~ TOWN 0 VilLAGE
AND W .
SPECIFY applnger
D STREET ADDRESS 17r:: r::anterbury Lane ZIP 12590
E IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES"tJ NO
M~H /1rly /1~j1
3. A. AGE39
4. EMPLOYMENT
38. DATE OF BIRTH
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A. USUAL OCCUPATION Carpenter
B. TYPE OF INDUSTRY OR BUSINESS r::on~tmction
5. PLACE OF BIRTHYM~~
(I , A COUNTRY IF NOT USA)
6. FATHER
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A. NAME Alexander Del Castello
B. COUNTRY OF BIRTH I J S P-
7. MOTHER
A MAIDEN NAME Sophie Kozara
8. COUNTRY OF BIRTH IJ 5 A
B NUMBER OF THIS MARRIAGE 2
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVil ANNULMENT
n
DEATH
o
1
8. HOW DID LAST MARRIAGE END? (3) ~ DIVORCE (3) 0 ANNULMENT (2) 0 DEATH
C DATE lAST MARRIAGE ENDED? M / 11 / ?006
MONTH DAY YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? ~YES 0 NO
10. IF PREVIOUSLY DIVORCED OR ANNUlED, PROVIDE THE FOllOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
04/11/2006 Pougbkeepsie, NY
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
L 0 SUPPLEMENTAL FILE
~
FROM THE BRIDE
11. A. FULL NAME Janice Marie Williamson
FIRST MIDDLE
CURRENT SURNAME
8. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C SURNAME AFTER MARRIAGE Del Castello
(OPTIONAL - SEE REVERSE)120-68-670 1
D. SOCIAL SECURITY NUMBER ---
12 RESIDENCE ANY B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY !"i TOWN 0 VillAGE
AND W .
SPECIFY applnger
D. STREET ADDREss17C Canterbury Lane
ZIP 12590
o YES '6 NO
1971
YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE?
13. A. AGE34 13.B. DATE OF BIRTH n5 is
MONTH DAY
14. EMPLOYMENT
A. USUAL OCCUPATION Bookkeeper
8. TYPE OF INDUSTRY OR BUSINESS Construction
15. PLACE OF BIRTHBronxville
(CITY, STATE/COUNTRY IF NOT USA)
16. FATHER
A. NAMEThomas R Williamson
B. COUNTRY OF BIRT~ S A
17. MOTHER
A. MAIDEN NAME Theresa R
B. COUNTRY OF BIRT~ S A
18. NUMBER OF THIS MARRIAGE 1
Mahone.y
19. 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
(2) 0 DEATH
(3) 0 ANNULMENT
/ /
C. DATE LAST MARRIAGE ENDED?
YEAR
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
20. IF PREVIOUSLY DIVORCED OR ANNUlED, PROVIDE THE FOllOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
f'!f
o 0
o 0
o 0
o 0
'mpediment exists
1ST
2ND
3RD
4TH
. f that the information I provided is trpe
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23. SUBSCRIBED AND SWORN TO BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK.
This license authorizes the marriage in New York State of the bride and groom named above by any person authorized
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 CITY CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
21. SIGNATURE OF GROOM
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{ SEAL }
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DATE
by New York Domestic
TIME
MONTH
NAME (PRINT)
YEAR
MONTH
YEAR
ZIP
AM
06:22 PM 04
27
2006
06
25 2006
CI
26. SOLEMNIZATION OCCURRED
TIME MO. DAY YEAR
STATE
27. TYPE OF CEREMONY
o 0 RELIGIOUS
9 0 OTHER, SPECIFY
1~
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY tJrtu4pt--
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF 0 TOWN OF ~AGE OF
SPECIFY /,J6-:Yt ~ Q ~ IA~ lie
J
TITLE IXI/o r .Ju j ,h:a.
5-12- Vb
l~f11...
STATE
ST
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICATED.
/2- 30 AM 5 - /Z-otJ:,
29. OFFICIANT AI (' If. / / S; 'JJ
NAME (PRINT) "fn." "'?'~fl1 el/1...t. h1 ,Tn
SIGNATURE. c~-"j.pA~ J J2..s-R
MAILING ADDRESS ~ ,/
2'1 /;J. /J1I1Ut Jj. U)~l4loTvh Vi<11e, }.If
STREET . CITYfTOWN J
30. WITNESS TO CEPff'.ONY .
NAME (PRINT)" vo.lef'1 e (1 )\ I i ,'amSOY1
SIGNATURE ~ l6.1MiL () ) jjiJ/'~
DOH.98 (11/9B)
DATE
31.
NAME (PRINT)
SIGNATURE.