009
COUNTY
CITYfTOWN
DISTRICT
NUMBER
REGISTER
NUMBER
Dutchess
WaDDinaer
na8" ,
9
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDA VIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Andrew C. Tedeschi
MIDDLE CURRENT SURNAME
I
STATE FilE NUMBER
(THIS SPACE FOR STATE USE ONLY)
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FIRST
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Coreen Serrano
..J
1. A. FUll NAME
11. A. FUll NAME
c.
N
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL, SEE REVERSE) OBe A" 2581
D. SDCIAl SECURITY NUMBER ~-
2. RESIDENCE A. New York B Dutchess
(STATE) J . (COUNTY)
C. CHECK ONE 0 CITY 0 roWN 0 VilLAGE
~~~CIFY Wappinger
62 Gold Road
D. STREET ADDRESS
FIRST MIDDLE
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT Hecht
c. SURNAME AFTER MARRIAGE Tedeschi
(OPTIONAL - SEE REVERSE) 101 62 8~55
D. SDCIAl SECURITY NUMBER - -....
12. RESIDENCE A. New York B Dutchess
(ST A TE) V' . (COUNTY)
C. CHECK ONE 0 CITY 0 TOWN 0 VilLAGE
~~~CIFY Wappinger
ZIP 12590 D. STREET ADDRESS 62 Gold Road
DYES 0 fa E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VilLAGE?
01 / 19 53. A. AGE 39 13.B. OATE OF BIRTH 12/
DAY YEAR MONTH
CURRENT SURNAME
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4. EMPLOYMENT
E. IS RESIDENCE WITHIN LIMITS OF CITY OR .INCORPORATED VilLAGE?
3. A. AGE 41 3B. DATE OF BIRTH 01/
MONTH
A. USUAL OCCUPATION Structure Foreman
B. TYPE OF INDUSTRY OR BUSINESS Metro North
5. PLACE OF BIRTH Bronx. New York
(CITY, ST A TElCOUNTRY IF NOT USA)
6. FATHER
A. NAME
14. EMPLOYMENT
A. USUAL OCCUPATION
.: 2590
ZIP
DYES 0 rto
22 / 1963
DAY YEAR
Un - Employed
B. COUNTRY OF BIRTH
Andrew l. Tedeschi
USA
B. TYPE OF INDUSTRY OR BUSINESS
15. PLACE OF BIRTH Bronx. ,..Jew York
(CITY. STATElCOUNTRY IF NOT USA)
16. FATHER
Alan Hecht
B. COUNTRY OF BIRTH USA
A. NAME
7. MOTHER
A. MAIDEN NAME
B. COUNTRY OF BIRTH
Ro~p.marip. Volpe
USA
2
17. MOTHER
A. MAIDEN NAME
B. COUNTRY OF BIRTH
Joan Miranda
USA
2
8. NUMBER OF THIS MARRIAGE
18. NUMBER OF THIS MARRIAGE
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
(3) M D~RCE
DEATH
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19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
(3) wi D1toRCE
DEATH
o
(2) 0 DEATH
2003
YEAR
(2) 0 DEATH
2001
YEAR
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21. SIGNATURE OF GROOM ~
22. SIGNATURE OF BRIDE ~
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23. SUBSCRIBED AND SWORN TO BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~ DATE
This license authorizes the marriage in New Yo of the bride and groom named above by any person authorized by New York Domestic
Relations Law ~11 to perform marriage ceremonies ithin 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
{ } NAME (PRINT) Glori
TIME MONTH
SEAL SIGNATURE ~ 02103/20
\...- -J MAILlN~tf~asdlebush Rd F lis. NY 12590 AM
-yo- STREET STA ZIP 01 :~
I CERTIFY THAT I SOLEMNIZED 27. TYPE OF CEREMONY
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE 0 0 RELIGIOUS
DATE AND AT THE TIME AND
PLACE INDICATED. 9 0 OTHER, SPECIFY
02/03/2003
~IVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY~S
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF )i('rOWN OF 0 VILLAGE OF
SPECIFY WQ...,r~ \ ~ P .r
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29. OFFICIANT
NAME (PRINT)
TITLE ~.rll'-;t1~e ~ce r
DATE r2j9l "'1 h '3
(