192
23. SUBSCRIBED AND SWORN TO BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New York S ate of the bride and groom named above by any person authorized
Relations Law ~11 to perform marriage ceremonies within New York State. THIS LICENSE VALID IN NEW YORK STATE ONLY.
,.... 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 (PRIN Elaine Town Clerk
TIME MONTH DAY YEAR
SEAL SIGNATURE~ DATE 9/29/00
\...- .-..J MAJIJNQAODXDRESs.. 4 , AM
-v- .l:"U.lSc Jl Wappingers Falls, NY 12590 3 '.00 PM 9
STREET CITYfTOWN STATE ZIP
I CERTIFY THAT I SOLEMNIZED 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
THE MARRIAGE OF THE PER.
SONS NAMED ABOVE ON THE TIME M. DAY YEAR 0 0 RELIGIOUS
DATE AND AT THE TIME AND ~I) *'* 0 0
PLACE INDICATED. ~ PM 10 90 OTHER. SPECIFY
~~ti~~~~T~1/. ~ '1r.--7. h :<.J<P''';
SIGNATURE~_ ~~
MAILING A9)l~
" /(I!.sSIQ r/ 01 ~ fL 1J4FP IN 9€.~
STREET CITYITOWN
30. WITNESS TO CEREMONY
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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Thomas
FIRST
COUNTY
~ITOWN
DISTRICT
NUMBER
REGlSTt:R
NUMBER
Dutchess
Wappinger
1368
192
1. A. FULL NAME
O'Connell
CURRENT SURNAME
MIDDLE
8. BIRTH NAME. IF DIFFERENT
C SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE)
D. SOCIAL SECURITY NUMBER
2. RESIDENCE A. New York B. Du tchess
(STATE) (COUNTY)
C CITY ~ TOWN 0 VILLAGE
Poughkeepsie
o STREET ADDRESS 306 Hudson Harbour
093-60-9823
C. CHECK ONE
AND
SPECIFY
12601
ZIP
E. IS RESIDENCE WITHiN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES 00 NO
/ 29 /1967
DAY YEAR
3. A. AGE
33
July
MONTH
3B. DATE OF BIRTH
4. EMPLOYMENT
A. USUAL OCCUPATION Accountant
B. TYPE OF INDUSTRY OR BUSINESS Tishman Interiors
5. PLACE OF BIRTH Manhattan, New York
(CITY. STATE COUNTRY IF NOT USA)
...
S;
c(
6. FATHER
A. NAME
B. COUNTRY OF BIRTH
7. MOTHER
A. MAIDEN NAME
B. COUNTRY OF BIRTH
8. NUMBER OF THIS MARRIAGE
Noreen Broderick
USA
First
Patrick O'Connell
USA
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
B. HOW DID LAST MARRIAGE END?
i 31 = DIVORCE
(2) 0 DEATH
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
MONTH DAY
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
YEAR
o
21.
w
en
z
w
(.)
~
,-
STATE FILE NUMBER
(THIS SPACE FOR STATE USE ONL Y)
I
.~ )olf316D
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
Dawn E.
~
Nikles
11. A. FULL NAME
FIRST
MIDDLE
CURRENT SURNAME
McGrath
O'Connell
082-66-0171
8. BIRTH NAME ,MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE)
o SOCIAL SECURITY NUMBER
12. RESIDENCE A. New York B. Dutchess
iSTATE) (COUNTY)
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
~~~CIFY Poughkeepsie
D STREET ADDRESS 306 Hudson Harbour ZIP 12601
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES ro NO
13. A. AGE 34 13.B.DATEOFBIRTH June /21 /1966
MONTH DAY YEAR
14. EMPLOYMENT
A. USUAL OCCUPATION S tuden t
B. TYPE OF INDUSTRY OR BUSINESS Dutchess Corom. College
15. PLACE OF BIRTH Poughkeepsie. New York
(CITY. STATE/COUNTRY IF NOT USA)
16. FATHER
A. NAME
B. COUNTRY OF BIRTH
17. MOTHER
A. MAIDEN NAME
B. COUNTRY OF BIRTH
Jeffrey McGrath
USA
Carol Westover
USA
Second
18. NUMBER OF THIS MARRIAGE
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
One
DEATH
B. HOW DID LAST MARRIAGE END? (3) ~ DIVORCE ,31 :J ANNULMENT (21 0 DEATH
C. DATE LAST MARRIAGE ENDED? J an. / 21 /1992
MONTH DAY YEAR
o ARE ANY FORMER SPOUSE(S) ALIVE? x: YES = 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
1/21/92 Poughkeepsie, NY
1ST
2ND
3RD
4TH
that the Information I provided is true
r
=
Town Clerk
DATE
Sept. 29, 200C
by New York Domestic
25. B. SOLEMNIZATION PERIOD
ENDS AT MIONIGHT ON:
MONTH
DAY
YEAR
30
00
11
28
00
1 6l.. CIVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B COUNTY 'Z11;c.Jt€ >~
TITLE reRn"liUC. TOCll~ \f'lX,.dr ~2. I
DATE (Jd :J...I, ~d06
,
FAu--3 N.Y _ 1:J...sq D
STATE
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF rs( TOWN OF 0 VILLAGE OF
SPECIFY fb c.J 9-ff fo',Ee:.P ~ c Eo
('
SIGNATURE