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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Aaron Bracley Simpfenderfer
FIRST MIDDLE CURRENT SURNAME
COUNTY Dutchess
CITYfTOWN:::PfAnoer
DISTRICT 1
NUMBER
REGISTER 155
NUMBER
1. A. FULL NAME
11.
N
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE)501_11_1058
D. SOCIAL SECURITY NUMBER
2. RESIDENCE A. Nevv York B. Dutchess
(STATE) J (COUNTY)
C. CHECK ONE ugh CITY LI TOWN 0 VILLAGE
AND P ...........i
SPECIFY 0 ~e
D. STREET ADDRESS ffl Hills Terrace ZIP 12603
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VIULAGE? 0 YES ~ NO
3. A. AGE 18 3B. DATE OF BIRTH 10 /27 /1987
MONTH DAY YEAR
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4. EMPLOYMENT
A. USUAL OCCUPATION Military
B. TYPE OF INDU~RY Of!. ~SIN..E~S~nIted states Navy
5. PLACE OF BIRTH ~rI.gn, NOm D8kct8
(CITY. STATE/COUNTRY IF NOT USA)
6. FATHER
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A. NAME Michael D. Simpfenderfer
B. COUNTRY OF BIRTH U 6 A
7. MOTHER
A. MAIDEN NAME Usa M. Zander
B. COUNTRY OF BIRTH USA
8. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
D1VC5CE CIVIL AN~LMENT
DEATH
o
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE (3) 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? / /
MONTH DAY YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 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
I
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
11. A.
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
FULL NAME Lori Anne Turner
FIRST MIDDLE
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CURRENT SURNAME
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Simpfenderfer
(OPTIONAL - SEE REVERSEl064-72-8176
D. SOCIAL SECURITY NUMBER
12. RESIDENCE A. Nevv Yark B. Dutchess
(STATE).J (COUNTY)
C. CHECK ONE Q CITY C'f TOWN 0 VILLAGE
~~~CIFY WaPPl~
D. STREET ADDRESS 58 Lene Gate R08CI
ZIP 12590
OYES~NO
1987
YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE?
13. A. AGE 18 13.B. DATE OF BIRTH 04 .89
MONTH DAY
14. EMPLOYMENT
A. USUAL OCCUPATION student
B. TYPE OF INDUSTRY OR BUSINESS M= st. Mary's
15. PLACE OF BIRTH Johnson CIty, YOiIC
(CITY, STATE/COUNTRY IF NOT USA)
16. FATHER
A. NAME Joseph M. Turner
B. COUNTRY OF BIRTHU 6 A
17. MOTHER
A. MAIDEN NAME Marianne De Sentls
B. COUNTRY OF BIRTHU S A
18. NUMBER OF THIS MARRIAGE 1
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 (3) 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? / /
MONTH DAY YEAR
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
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1ST 0 0 1ST 0 0
2ND 0 0 2ND 0 0
3RD 0 0 3RD 0 0
~ 0 0 ~ 0 0
I, being duly sworn, depose 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 marriage state. 0 _.1 _
21. SIGNATUREOFGROOM~ ~ NATUREOFBRIDE~ ~Y-l -\IiAN r
USE CURRENT NAME
1 the bride and groom named above by any person authorized by New York Domestic
York State. THIS LICENSE VALID IN NEW YORK STATE ONLY_
used only for the purpose 01 a second or subsequent ceremony.
25. A. SOLEMNIZATION PERIOD BEGINS
1212712005 TIME
'-ftd;~Wappnger Falls, NY 12590 09:03 ~~
CITY/TOWN STATE ZIP
26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
TIME MO. DAY YEAR 0 Jz{ RELIGIOUS 1 0 CIVIL
oS- 9 0 OTHER, SPECIFY
?A5T61Z..
12 -28- oS-
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STREET
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICATED.
TITLE
DATE
MONTH
YEAR MONTH
YEAR
12 28 2005 02 25 2006
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY Du~
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF Pt TOWN OF 0 VILLAGE OF
SPECIFY
i.€J
ZIP
31. WITNESS TO CEREMONY
NAME (PRINT) )11 (). r ; 0. n 11 e IU r VI e r
SIGNATURE~ ll'\~ T~