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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Damian J. Alaimo
Dutchess
COUNTY \MIppI
CITYITOW~368 nger
DISTRICT
NUMBER 32
REGISTER
NUMBER
1. A. FULL NAME
MIDDLE
CURRENT SURNAME
FIRST
..
N
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE) U6tS->>;:RS03
2 ~~s~::~~~~CU~'ork B. Orange
(STA~ ,. (COUNTY)
C. XljfiCK ONE NeWbIl~ TOWN 0 VILLAGE
SPECIFY 447 FI...t Sb~
D. STREET ADDRESS
12550
ZIP '"
~ Y~;P1W7
DAY YEAR
E. IS RESI~E WITHIN LIMITS OF CITY OR INCORPORATED VllftfE?
3. A. AGE 3B. DATE OF BIRTH /
MONTH
4. EMPLOYMENT
Health Care Administrator
A. USUAL OCCUPATION .. II A ......--01 I .....
",yon. _RNt:N .....ng
B. TYPE OF INDUS~orr JiIMon New Yotk
5. PLACE OF BIRTH '
(CITY, STATE/COUNTRY IF NOT USA)
6. FATHER Ja Alai
A NAME mes,. mo
B: COUNTRY OF BIRTH USA
7. MOTHER
Cathy Olson
A. MAIDEN NAME USA
B. COUNTRY OF BIRTH 1
8. NUMBER OF THIS MARRIAGE
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIV01)E CIVIL ANN~MENT
DEA~
B. HOW DID LAST MARRIAGE END? (3) D' DIVORCE
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
(2) 0 DEATH
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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
o
o
o
21. SIGNATURE OF GROOM ~
23. SUBSCRIBED AND SWORN TO BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage
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STATE FILE NUMeER
(THIS SPACE FOR STA TE USE ONL YI
I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Elizabeth S. Oyer
~
11. A. FULL NAME
MIDDLE
CURRENT SURNAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF ~E~NT
C. SURNAME AFTER MARRIAGE Blmo
(OPTIONAL. SEE REVERSE) 3r4l-96-9628
D. SOCIAL SECU~lr~NU~R
12. RESIDENCE A. NeW ork B. Orange
(STAT!ijIJ (COUNTY)
C. CHECK ONE", . __ _ 1;;:[ P!n.. 0 TOWN 0 VILLAGE
AND NeWDUrUn
SPECIFY 447 First Sb'eet 12S50
D. STREET ADDRESS ZIP
'"
E. IS RESID~E WITHIN LIMITS OF CITY OR INCORPORATED ~GE? CJ51 YES ~"f1
13. A. AGE 13.B. DATE OF BIRTH / L!.!
MONTH DAY YEAR
14. EMPLOYMENT
A. USUAL OCCUPATION ornce M~Dr1Iid HeiIII'I
B. TYPE OF INDUSra~USIN.dI fa . ng
15. PLACE OF BIRTH ng, gII
(CITY, STATE/COUNTRY IF NOT USA)
16. FATHER M rk Oy
A NAME a er
B: COUNTRY OF BIR'(H USA
17. MOTHER
A. MAIDEN NAME Susan Donovan
B. COUNTRY OF BIRTH USA
18. NUMBER OF THIS MARRIAGE 1
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
D1V~CE CIVIL ANN~MENT
DEA~
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
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
York Domestic
TIME
MONTH
YEAR
TE
Falls, NY 12590 12:ot~
STR ET
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE QN THE
DATE AND AT THE TIME AND
PLACE INDICATED.
04
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'1- ~(,;.- :2J9f) '3
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28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY CJI:../JAJ6-E.
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
"f( CITY OF 0 TOWN OF 0 VILLAGE OF
SPECIFY A//EZVIJUR6-ff-
27. TYPE OF CEREMONY
O)(RELlGIOUS 10 CIVIL
9 0 OTHER, SPECIFY
TITLE
SIGNATURE