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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDA VIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Craig S.
FIRST MIDDLE
3. HOW DID LAST MARRIAGE END? 13) IX DIVORCE ,31 c:: ANNULMENT
C. DATE LAST MARRIAGE ENDED? July / 1') /
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? J!'iES == NO
,0. IF PREVIOUSLY DIVORCED OR ANNULED. PROVIDE THE FOLLOWING INFORMATION 20.
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH. DAY. YEAR) ICITY. STATE/COUNTRY. IF NOT USA) SELF SPOUSE
1ST 7/15/97 Broward Co. Florida ~ 1ST
2ND == 2ND
3RO C 3RD
4TH == 4TH
I. tieing duly sworn, depose and say, that tD the best of my knowledge and belief that the infDrmation I provided is true and that I declare that nD legal impedimen
as to my right to enter intD the m . ge sta!e. ~. '
21 SIGNATURE OF GROOM. 22. SIGNATURE OF BRIDE.
COUNTY
~OWN
DISTRICT
NUMBEiil
REGISTER
NUMBER
Dutchess
WaDpinger
1368
155
A. FULL NAME
Oliveri
CURRENT SURNAME
"-
N
BIRTH NAME. IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE) 064-66-2536
D. SOCIAL SECURITY NUMBER
2. RESIDENCE A. NpT.V York B. nllt"('hpqq
,STATE) (COUNTY)
:::: CITY [Jt TOWN [] VILLAGE
Wappinger
4C Wildwood Manor
C. CHECK ONE
AND
SPECIFY
4. EMPLOYMENT
12590
YES i1!I NO
A970
YEAR
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A. USUAL OCCUPATION Software Tester
B. TYPE OF INDUSTRY OR BUSINE$S CRS Retail Systems
5. PLACE OF BIRTH Bavshore. New York
(CITY. il'fATElCOUNTRY IF NOT USA)
6. FATHER
A. NAME Richard T. Oliveri Sr.
B. COUNTRY OF BIRTH USA
7. MOTHER
A. MAIDEN NAME Karen R. Haderer
B. COUNTRY OF BIRTH HC:: A
8 NUMBER OF THIS MARRIAGE Secoud
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
Onp
(2) C DEATH
1997
YEAR
,- STATE FILE NUMBER I
(THIS SPACE FOR STATE USE ONL Y)
/ql~C\O IJ
Lo SUPPLEMENTAL FILE .-J
11. A. FULL NAME
FROM THE BRIDE
Allison D. Rentfro
FIRST MIDDLE CURRENT SURNAME
B. BIRTH NAME [MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE Oliveri
(OPTIONAL - SEE REVERSE) 2 6
D. SOCIAL SECURITY NUMBER 1- 85-144 6
12. RESIDENCE A Np.IaZ York B. nllt"l'hpqq
. (STATE) (COUNTY)
C. CHECK ONE 0 CITY [JtTOWN [] VILLAGE
AND
SPECIFY Wappinger
D STREET ADDRESS 4C Wildwood Manor ZIP
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES m NO
13.A. AGE 26 13.B.DATEOFBIRTHFeb. /02 /1974
MONTH DAY YEAR
14. EMPLOYMENT
A. USUAL OCCUPATION Loan Reviewer
B. TYPE OF INDUSTRY OR BUSINESS Premier National Bank
15. PLACE OF BIRTH KinQ:ston. New York
(CITY. ST~E/COUNTRY IF NOT USA)
16. FATHER
A. NAME James L. Rentfro III
B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME
Terrv A. Avis
B. COUNTRY OF BIRTH HC:: A
18. NUMBER OF THIS MARRIAGE Firs t
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
B. HOW DID LAST MARRIAGE END?
(3) C DIVORCE
C. DATE LAST MARRIAGE ENDED?
13) C ANNULMENT
/ /
(2) [] DEATH
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? == YES == NO
IF PREVIOUSLY DIVORCED OR ANNULED. PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH. DAY. YEAR) ICITY. STATE/COUNTRY. IF NOT USA) SELF SPOUSE
YEAR
==
---,
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W
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::::;
NAME (PRINT)
SIGNATURE.
00H-lI8 (1198)
23. SUBSCRIBED AND SWORN TO BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in N York State of the bride and groo 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.
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)~aine H. rS~owden. Town Clerk TIME MONTH DAY YEAR
SEAL SIGNATURE .f:iallU ~ ~d.J,_
M~Jl.!NQ.ADDRE.sli 8: 45 AM 09 07 00
"-v--I J:'U .Box 314 Wa in ers Falls PM
S C WN A
I CERTIFY THAT I SOLEMNIZED 26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
THE MARRIAGE OF THE PER-
SONS NAMED ABOVE ON THE TIME DAY YEAR g;:g:: RELIGIOUS
DATE AND AT THE TIME AND AM ....:7V.
PLACE INDICATED. PM (LoU 9 C OTHER. SPECIFY
~AtJti~~~N~T ~~~ ell\. TITLE W\ I v\ \.S~ r-
SKiNATURE. ~aJ l~ /L~ ~ DATE qllf.~
MAILING ADDRESS - .I..j 7
S1R!ef A'/"c-iU/~t !rv~~~~ #~~ /V'Ftd Yf.r1Tt
30. WITNESS TO CE EMONY
Town Clerk
6.2000
Domestic
25. B. SOLEMNIZATION PERIOD
ENOS AT MIDNIGHT ON:
MONTH
DAY
YEAR
11
05
00
28. PLACE WHERE MARRIAGE OCCURRED
1:::: CIVIL
A. STATE NEW YORK B. COUN~
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF 0 TOWN OF)S. VILLAGE OF
SPECIFY W<=-fPI ~ --rQ...1 J5
N'J/ /LJ~.2.5
, ZIP
31. WITNESS TO CEREMONY
NAME (PRINT) 'P fl U L L.. E M'" 6 N
SIGNATURE.P~ ~