135
STATE OF NEW YORK I STATE FILE NUMBER I
COUNTY Dutchess (THIS SPACE FOR STATE USE ONLY)
- CITYfTOWN =PfAngfJr DEPARTMENT OF HEALTH
DISTRICT 1 AFFIDAVIT, LICENSE and
NUMBER
REGISTER 135 CERTIFICATE OF
NUMBER
MARRIAGE Lo SUPPLEMENTAL FILE ~
FROM THE GROOM FROM THE BRIDE
1. A. FULL NAME Joseph Sabatelli 11. A. FULL NAME Adrienne M. Raab
FIRST MIDDLE CURRENT SURNAME FIRST MIDDLE CURRENT SURNAME
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23. ~~~..fT~~~DO~N,oO~O~~ ~'iv C~~~~E DATE 10108I2OO4
This license authorizes the marriage in New York Stat of the bride and groom named above by any person authorized by New York Domestic
Relations Law ~11to perform marriage ceremonies within w York State. THIS LICENSE VALID IN NEW YORK STATE ONLY.
o If checked, this license is to be used only for the pu ose of a second or subsequent ceremony.
~ 24. TOWN OR CITY CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
{ } NAME (PRINT) Gloria J; ~orse TIME MONTH
SEAL SIGNATURE ~ -- TE 10108I2OO4
'-.t-" MA~i.iafi~ R Falls NY 12590 AM 10
STREET C {TOWN SATE IP 01:44PM
I CERTIFY THAT I SOLEMNIZED 26. SOLEMNIZATION OCCURRED 2"}( PE OF CEREMONY
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE TIME MO. AY R 0 RELIGIOUS 1 0 CIVIL
~tl~E ~~glJTJ~E TIME AND ~ / ~ /" 0 Y 9 0 OTHER, SPECIFY
29. OFFICIANT 1< G ITJ.I- W, --r Y1.jJt /.-1 N' TITLE /f7 e ~
NAME (PRINT) ~ J 1"7' Jc....
SIGNATURE~ J~ t~Mj~~ / -;:::- ;~TE
/'-?tg-ESS~Si'u :1116 ;:;~ji c- ~ H. 't
STREET CITYfTOWN ~ 7 STATE
30. WITNESS T
0.
N
8. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE) Q6O.. 70-9968
D. SOCIAL SECURITY NUMBER
2 RESIDENCE A. New York
(STATE) ..J
C. CHECK ONE 0 CITY LJ TOWN 0 VILLAGE
D. ::~~ ADD:~"Mv.rs corners Road
B.
Dutchess
(CouNTY)
ZIP 12590
E. IS RESIDENCE WITHIN UMITS OF CITY OR INCORPORATED VILLAGE? 0 YES r:f NO
07 / 03 /' 1976
MONTH DAY YEAR
3. A. AGE 28
3B. DATE OF BIRTH
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4. EMPLOYMENT
A. USUAL OCCUPATION C 0 Su~r
B. TYPE OF INDUSTRY OR BUSINESS Frontier COmmunications
5. PLACE OF BIRTH Poughk8epsle, New York
(CITY, STATE/COUNTRY IF NOT USA)
6. FATHER
A. NAME Richard A Sabatelli
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Virginia Vlncenzl
B. COUNTRY OF BIRTH USA
B. NUMBER OF THIS MARRIAGE 1
9. 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
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /'
(2) 0 DEATH
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
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8. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Sab8t.elli
(OPTIONAL - SEE REVERSE) 05".1'-74-7910
D. SOCIAL SECURITY NUMBER oil"
12. RESIDENCE A. New York B. Dutchess
(STATE).....ML (COUNTY)
C. CHECK ONE 0 CITY Lf"IOWN 0 VILLAGE
~~CIFY Beekman
D. STREET ADDRESS 30 Ashby Road ZIP 12570
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES r:I NO
12 /07 /l9n
MONTH DAY YEAR
13. A. AGE 26
13.B. DATE OF BIRTH
14. EMPLOYMENT
A. USUAL OCCUPATION Nanny
B. TYPE OF INDUSTRY OR BUSINESS Babvslttlna
15. PLACE OF BIRTH Sharon, Connecticut
(CITY, STATE/COUNTRY IF NOT USA)
16. FATHER
A. NAME James Rub
B. COUNTRY OF BIRTH U S A
17. MOTHER
A. MAIDEN NAME Deborah Widman
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
B. HOW DID lAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
(2) 0 DEATH
o
o
o
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
o 0
o 0
o 0
o 0
o legal impediment exis1s
. SIGNATURE OF BRIDE
YEAR
28. PLACE WHERE MARRIAGE OCCURRED . /
A. STATE NEW YORK B. COUNT-:Q//'t~eJ
/;:.s-<j 0
C. LOCATION OF CEREMONY
(CHECK OiEAND SPECIFY)
o CITY OF OW~ OF 0 VILLAGE OF
SPECIFY . ifJ j~