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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
FIR~rik Andr~D~ykolas I 'M~M1~tP
1ST 0 0 1ST 0 0
2ND 0 0 2ND 0 0
3RD 0 0 3RD 0 0
4TH 0 0 4TH 0 0
I duly swear/affirm, 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
as to my right to enter into the marriage statpj , ~
21 SIGNATURE OF GROOM ~ -L-..A/lJ'- - ~ 22. SI ATURE OF BRIDE ~ ~ ~ ~ 0 /"\.. ~
USE CURREN AM Y USE CURRENT NAME
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME )( 07~22/201 0
SIGNATURE OF TOWN OR CITY CLERK ~ ,'-.-; DATE
This license authorizes the marriage in New York State of the bride and groom named above by any person authorized by New York Domestic
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
DATE 07/22/2010 TIME
. 10:38AM
In ers Falls NY 12590 PM
ITYIT WN STATE ZIP
26. SOLEMNIZATION OCCURRED 27. TYPE OF CEREMONY
TIME MO. DAY YEAR ~ RELIGIOUS
9 0 OTHER, SPECIFY
'm.E ~even
DATE ~t,; /io
~al!~ I/. Y. / N-9o
- STATE
COUNTY Dutchess
CITYfTOWN Wappinger
~~~:~c: 1368 .
~~~~J~R 89
1 . A. FULL NAME
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE)
D. SOCIAL SECURITY NUMBER
2. RESIDENCE A. NV
\STATE)
C. CHECK ONE 0 CITY .,2J
AND \M .
SPECIFY _ applnger
D. STREET ADDRESS 15RO Rnlltp. ~7R ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VilLAGE? 0 YESottJ NO
M~ / JA~ / ~E~R85
xxx-xx-xxxx
B. ~~ss
TOWN 0 VILLAGE
3. A. AGE 24
3B. DATE OF BIRTH
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4. EMPLOYMENT
A. USUAL OCCUPATION Student
B. TYPE OF INDUSTRY OR BUSINESS I'JVCr.
5. PLACE OF BIRTH Ontario Can~rl::l
(CITY, STATE /COUNTRY IF NOT USA)
6. FATHER
A. NAME Timo Uukiulainen
B. COUNTRY OF BIRTH Finl;mrl
7. MOTHER
A. MAIDEN NAME Irene p::lstllr.h
B. COUNTRY OF BIRTH Great Rriti::ln
8. NUMBER OF THIS MARRIAGE 1
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
DEATH
o
(2) 0 DEATH
o
o
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE LAST MARRIAGE ENDED?
(3) 0 ANNULMENT
/ /
MONTH DAY YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
10. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY/COUNTY, STATE/COUNTRY. IF NOT USA) SELF SPOUSE
a:
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{ SEAL }
'-y-I
29. OFFICIANT
NAME (PRINT)
NAME (PRINT)
STREET
I CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER.
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICATED.
SIGNATURE ~
MAILING ADDRES~ ..,...
/ s-6' tJ - J::-.Ot./le-
STREET
30. WITNESS TO CE~
NAME (PRINT)
SIGNATURE~
DOH-98 (09/2009)
I
STATE FILE NUMBER
(THIS SPACE FOR STA TE USE ONL Y)
I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
suzanMQ~LEKayle Ta~l~EQT SURNAME
~
11. A. FULL NAME
FIRST
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL. SEE REVERSE).. 60 66 6621
D. SOCIAL SECURITY NUMBER 'I - -
12. RESIDENCE,lNY BDutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
AND W .
SPECIFY applnger
D. STREET ADDREss1560 Route 376
ZIP 12590
o YEStJ NO
%984
YEAR
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VilLAGE?
13. A. AGE?!=; 13B.DATE OF BIRTH 08 ...61
MONTH DAY
14. EMPLOYMENT
A. USUAL OCCUPATION Student
B. TYPE OF INDUSTRY OR BUSINESS NYCC
15. PLACE OF BIRTHAbington. Pennsvlvania
(CITY. STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Keith Wray Tamlyn
'B. COUNTRY OF BIRTJ,,! S A
17. MOTHER
A. MAIDEN NAME Elizabeth Ann Oshel
B. COUNTRY OF BIRTJJ 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
/ /
- YEAR
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? 0 YES 0 NO
~
20. IF PREVIOUSLY DIVORCED OR ANNULLED, PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH, DAY, YEAR) (CITY/COUNTY, STATE/COUNTRY, IF NOT USA) SELF SPOUSE
MONTH
YEAR
MONTH
YEAR
07
23
2010
09
20 2010
10 CIVIL
28. PLACE WHERE MARRIAGE OCCURRE~ )
A. STATE NEW YORK B. COUNTY ~1IY'reh
c. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF )( TOWN OF 0 VILLAGE OF. k.
SPECIFY HIl({)l-e", rlt'w Yo,,-
II I