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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Andrew J. Hunter
COUNTY Dutchess
CITYfTOWN Wappinger
~~~~kCRT 1368
~5~liJ~R 113
1 A FULL NAME
MIDDLE
CURRENT SURNAME
FIRST
"-
N
BIRTH NAME, IF DIFFERENT
C SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE) 116-68-8784
D. SOCIAL SECURITY NUMBER
2 RESIDENCE A, N Y B, Dutchess
(STATE) J. (COUNTY)
C CHECK ONE 0 CITY 0 TOWN [J VILLAGE
~~~CIFY Wappingers Falls
o STREET ADDRESS 6 B Dutchess Avenue ZIP 12590
E IS RESIDENCE WITHiN LIMITS OF CITY OR INCORPORATED VILLAGE? ~ YES 0 NO
05 /26 / 197
3 A. AGE 25
38. DATE OF BIRTH
MONTH
DAY
YEAR
4. EMPLOYMENT
A USUAL OCCUPATION Associate
B TYPE OF INDUSTRY OR BUSINESS Home Depot
5, PLACE OF BIRTH Long Island, New York
(CITY, STATElCOUNTRY IF NOT USA)
6. FATHER
A, NAME Andrew Hunter
B COUNTRY OF BIRTH USA
7 MOTHER
A, MAIDEN NAME Frances Rechinda
8. COUNTRY OF BIRTH USA
8 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
I
ST ATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
I'
( ,0;"
't- II')
Ii
I
Jj7J;1;t
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Joette M. Richardson
~
", A FULL NAME
FIRST
MIDDLE
CURRENT SURNAME
B BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C, SURNAME AFTER MARRIAGE Hunter
(OPTIONAL - SEE REVERSE) 064-74-8492
o SOCIAL SECURITY NUMBER
12, RESIDENCE A, New York B. Ulster
(STATE)..; (COUNTY)
C CHECK ONE 0 CITY LJ TOWN 0 VILLAGE
~~~CIFY Pine Bush
D STREET ADDRESS 260 Ulstervllle I-<oad
ZIP 1 :Lobb
"
E, IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES 0 NO
08 /01 )f980
DAY
13 A, AGE 21
13.8. DATE OF BIRTH
MONTH
YEAR
14, EMPLOYMENT
A, USUAL OCCUPATION Teacher
8. TYPE OF INDUSTRY OR BUSINESS Valley central
15 PLACE OF BIRTH Middletown, New York
(CITY, STATE/COUNTRY IF NOT USA)
16. FATHER
A, NAME James Peter Richardson, Sr.
8. COUNTRY OF BIRTH U 0 A
17, MOTHER
A, MAIDEN NAME Catherine Busching
8. COUNTRY OF BIRTH USA
1
18. NUMBER OF THIS MARRIAGE
19, PREVIOUS MARRIAGES
A, NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DI~RCE CIVIL ANbULMENT
DE6TH
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
o
o
1ST
2ND
3RD
4TH
I, being duly sworn. depose and say. t
as to my right to enter into the marri
21 SIGNATURE OF GROOM~-
o
o
o
DATE
by New York Domestic
MONTH
YEAR
09
23 2002
STREET
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICATED
STATE
27, TJPE OF CEREMONY
o rii RELIGIOUS 1 0 CIVIL
e V 17)'" "! .'
o 2. 9 0 OTHER, SPECIFY
TITLE _p (4c:.,r 01....
DATE o"IIDI02-
fJ'i f1,)~b
"j'. I S- AM O~ 10
29 OFFICIANT !!y.. ,j f ~ L' o~
NAME (PRINT) .' {/ c;--o
;/ / J, 7
SIGNATURE ~ i C,v..A/ ~
MAILING ADDRESD . '-" ()
S b ~,/L c ~ A () {4 D ~ I N b v'Ih
STREET CITYiTOWN
30 WITNESS TO CEREMONY
~
NAME (PRINT)
SIGNATURE ~
DOH-98 (11/98)
28, PLACE WHERE MARRIAGE OCCURRED
A STATE NEW YORK 8. COUNTY
C LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF JlS.. TOWN OF 0 VILLAGE OF
SPECIFY
r- \,~ k,1 (
31,
NAME (PRINT)
SIGNATURE ~