100
J
"-
N
~
~
~
.:..!
L-
~
~
.;D
Z
w
(J) S
> if>
C
o
en
..c
m
~
~
~
~
~
~
~
:c
~
~
~
~
1!D
D
a:
11- a:
;: lli
(f) "
(f) ::>
w z
a: 0
o z
o <<
<< tuw
1:: a:
(] t-
W if>
Il.
(f)
t::
>
<(
C
w-
"LL.
:'iLL.
~<(
z
;:
o
t-
>-
t-
U
z z
a: 0 W
::> ;::
t- ~
W <(
a: N <(
t- Z
(f) " U
::> w
" 6 u:
t- (f)
Z r=
<( LL
(] 0 a::
it (f) w
0 >-
<( U
W 0
I- if>
0
Z ~
STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Anthony Liquori
MIDDLE CURRENT SURNAME
15T 0 0 15T 0 0
2ND 0 0 2ND 0 0
3RD 0 0 3RD 0 0
4TH 0 0 4TH 0 0
I, being duly sworn, depose and say, that to the best of my knowledge and belief that the information I provided is true and that I declare that no legal impediment exists
:~t:I:~:~~:~oo:n~:~:::e marr~ge state. 22. SIGNATURE OF BRIDE ~ a~j,t? t/Dbob
~ USfiltRRENT NAME
23. ~~~;T~~~DO~NT~~OtRN 6;~Bg~~~~E DATE 07/11/2002
This license authorizes the marriage in ate of the bride and groom named above by any person authorized by New York Domestic
Relations Law ~11 to perform marriage ceremonies wit' 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)GIO~ J. Morse TIME YEAR MONTH
SEAL SIGNATURE ~ ( 1/11/2002
'-v-I ~&I~rame sush Rd in r Falls NY 12590 2002 09 09 2002
STREET CITYITOWN STATE ZIP
I CERTIFY THAT I SOLEMNIZED OCCURRED 27. TYPE OF CEREMONY
~~~SM~~~tg~B~vJH5/iH~ DAY YEAR 0 ~RELlGIOUS
DATE AND AT THE TIME AND
PLACE INDICATED. Zoo"l., 90 OTHER, SPECIFY
TITLE Re V"eYlI"\J
DATE j flwtvS+ 2a?2..
I z. SOB'
ZIP
31. WITNESS TO CEREMONY
COUNT,Qutchess
CITYfTOWNWappinger
~~~~~CR" 368
~5~I~J~RJOO
A. FUll NAME
FIRST
B BIRTH NAME. IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSIii 32 66-2460
D SDCIAl SECURITY NUMBER I -
2. RESIDENCE ANew York B. Putnam
(STATE) J (COUNTY)
C CHECK ONE 0 CITY""D TOWN 0 VILLAGE
~~~CIFY Southeast
D. STREET ADDRES~4 Orchard Court ZIP 1 0509
E IS RESIDENCE WITHiN LIMITS OF CITY OR INCORPORATED VilLAGE? 0 YEs.,lb NO
/21 /1916
DAY YEAR
3. A AG~6
06
MONTH
38. DATE OF BIRTH
4. EMPLOYMENT
A. USUAL OCCUPATIONEnqineer
8. TYPE OF INDUSTRY OR BUSINESJ:ire Systems
5. PLACE OF BIRT.l3ronx. New York
(CITY. STATE/COUNTRY IF NOT USA)
6. FATHER
A. NAME Anthony Liquori
B COUNTRY OF BIRTJtalv
7. MOTHER
A. MAIDEN NAME Donna Sampugnaro
B. COUNTRY OF BIRTHU SA
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
(3) 0 ANNULMENT
/ /
(2) 0 DEATH
C DATE LAST MARRIAGE ENDED?
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
w
en
z
w
u
:::::i
N~
SATE
I
&at
I
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
I'l
$ 'v.t~1
L D SUPPLEMENTAL FILE
FROM THE BRIDE
Elizabeth Beale
~
11. A. FUll NAME
FIRST
MIDDLE
CURRENT SURNAME
B BIRTH NAME (MAIDEN NAME). IF DIFFERENT
C. SURNAME AFTER MARRIAGE Beale - liquori
(OPTIONAL - SEE REVERSEn50-62 9468
D. SOCIAL SECURITY NUMBER U -
12. RESIDENCE ,New York BDutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY '6 TOWN 0 VILLAGE
AND \AI .
SPECIPI""!' applnger
D. STREET ADDRESse 0 !lOX 356 New Hamburg
ZIP12531
o YES"'o NO
'W71
YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VilLAGE?
13. A. AGEl4 13.8. DATE OF BIRTH 09 2'4
MONTH DAY
14. EMPLOYMENT
A. USUAL OCCUPATION Teacher
8. TYPE OF INDUSTRY OR BUSINEsJ,'MappinQers Central School
15. PLACE OF BIRTtf'ouahkeepsie: New York
(CITY, STATE/COUNTRY IF NOT USA)
16. FATHER
A. NAMJohn Beale
B. COUNTRY OF BIR.JJ S A
17. MOTHER
A. MAIDEN NAMd<atherine Holohan
B. COUNTRY OF BIR.JJ S A
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
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
YEAR
10 CIVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK 8. COUNTY })4lc~e<;.5
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
~CITY OF 0 TOWN OF
SPECIFY BettCon
o VilLAGE OF
NAME (PRINT)
SIGNATURE ~