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1. A. FUll NAME
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
R*rt Paul F~go
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
COUNTY Dutchess
CITyrrOWN WappiRger
DISTRICT
~~~~~~R1368
NUMBER 90
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L 0 SUPHLEMENTAL FILE
FROM THE BRIDE
CURRENT SURNAME
11. A FUll NAME TOIi'~STJe8n Oi NMLl'o
CURRENT SURNAME
B BIRTH NAME, IF DIFFERENT
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. S~~~~JN~~~~~t':e~~Ji emlf8
D. SOCIAL SECURITY NUMBER 07 4-72-aaO~ .
12 RESIDENCE A'Ne*A~~rk B. O~5
C. ~~6CK ONE 0 CITY 0 TOWN ~ VILLAGE
SPECIFYWoppingef3 Falls
D. STREET ADDREss2521 South ANeRlIe ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VilLAGE? rA YES ~ NO
UNTH ft5DAY 1~76AR
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE)
D SOCIAL SECURITY NUMBER OD7 ~58-D117
2 RESIDENCE A N"T~ofk B. ~S3
C ~~6CK ONE 0 CITY 0 TOWN ~ VILLAGE
SPECIFY WappiRgers Falls
D STREET ADDRESS 2521 South A'!enue ZIP 12590
E IS RESIDENCE WITHiN LIMITS OF CITY OR INCORPORATED VILLAGE? iJ YES rJ NO
MR / OSy / t8i2
13. A. AGE29
14. EMPLOYMENT
13.B. DATE OF BIRTH
3. A. AGE 42
4. EMPLOYMENT
3B. DATE OF BIRTH
A USUAL OCCUPATION Office Manager
B. TYPE OF INDUSTRY OR BUSINESS B & B Auto Specialists
15. PLACE OF BIRTHP~~M~ Yol'k
16. FATHER
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A. USUAL OCCUPATION Retired
B. TYPE OF INDUSTRY OR BUSINESS
5. PLACE OF BIRTHt\I~~~Ny~rt
6. FATHER
A. NAME Philip John Di Nonno II I
8. COUNTRY OF BIRTftJ S A
17. MOTHER
A. MAIDEN NAME r elitia Zullo
B. COUNTRY OF BIRTftJ S A
18. NUMBER OF THIS MARRIAGE 2
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
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A NAME Palll FerraF8
8. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Catherine Lonergan
B. COUNTRY OF BIRTH USA
8. NUMBER OF THIS MARRIAGE 2
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
o
(3) 0 ANNULMENT (2) 0 DEATH
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1
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(3) ~ DIVORCE
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(3) 0 ANNULMENT (2) 0 DEATH
/2RD4
C DATE LAST MARRIAGE ENDED? -.1]3 / 1..1:
MONM !!1M
D. ARE ANY FORMER SPOUSE(S) ALIVE? iii 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
o
B. HOW DID LAST MARRIAGE END? (3)e DIVORCE
C. DATE LAST MARRIAGE ENDED? n~ / '2R
MONTff"" 0lI,,.
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
B. HOW DID LAST MARRIAGE END?
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1ST 01!2BQ004 poughkeepsie, New YOr<<
2ND
3RD
4TH
I, being duly sworn, depose ands..~. .y,..t 0 th
as to my right to enter into the marrja t
21. SIGNATURE OF GROOM" '/ ';(
'" 0 1ST 03-/16/1999 Poughkeepsie, New Yol'k
o 0 2ND
o 0 3RD
o 0 4TH
owledge and belief that the information I provided is true and that I d
--
22. SIGNATURE OF BRIDE ..
23 ~" ./".I~ 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 CITY CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
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{ SEAL }
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YEAR
MONTH
YEAR
TIME
MONTH
NAME (PRINT)
SIGNATURE ..
MAILING ADDRES
DATE08l17,Q005
AM
PM 08
16 2005
18
2005
10
ZIP
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY!1t ~kq
C LOCATION OF CEREMONY
(CHECK ONE AND SP CIFY)
o CITY OF TOWN OF 0 VilLAGE OF
SPECIFy~~-r ;:;'.;J /(j 1/
S
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER.
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICATED.
~
29. OFFICIANT
NAME (PRINT)
NAME (PRINT)
SIGNATURE ..