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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFtDA VIT, LICENSE and
CERTIFICATE OF
4'" MARRIAGE
FROM THE GROOM
B. HOW 010 LAST MARRIAGE END? 13\ ~ DIVORCE 13\ 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? Anr; 1 / 1 R / 1 QQ7
MONTH DAY YEAR
D. ARE ANY FORMER SPOUSE(S\ ALIVE? ~ YES ::J NO
'0. 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
4/18/97 Dutchess Co. New York 0 E 1ST
C 2ND
o 3RD
C 4TH
Dwledge and belie that the information I provided is /!ir t~at I decl~re that n
22. SIGNATURE OF BRIDE ~
23. SUBSCRIBED AND SWORN TO BEFORE ME
SIGNATURE OF TOWN OR CITY CLERK ~
This license authorizes the marriage in New York State 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.
o If checked, this license is to be used onl for the u se of a second or subsequent ceremony.
24. TOWN OR C CLERK 25. A. SOLEMNIZATION PERIOD BEGINS
Elai e Town Clerk
DATE 7/26/00
NY 12590
COUNTY
:"".DtY /TOWN
blSTRICT .
NUMBER
REGISTER
NUMBER
Dutchess
Wappinger
1368
170
I
STATE AU:__
(THIS SPACE FOR STATE USE ONLY)
, . A FULL NAME
Peter
FIRST
M. SaRRano
MIOOLE CURRENT SURNAME
,.1/ ~301()U
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
~
B. BIRTH NAME, IF DIFFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL' SEE REVERSE)
D. SOCIAL SECURITY NUMBER 089-68-1170
2. RESloENCEA. New York B. ntlt:C.hF!RR
IS~) IcoUN'l'i')
C. CHECK ONE 0 CITY ~ TOWN ::J VilLAGE
AND W'
SPECIFY appJ.nger
D STREET ADDRESS U tJ1..li t: F! ~-"I t: p R nAp t: lip
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VilLAGE? C
3. A. AGE 10 3B. DATE OF BIRTH Apr; 1 /0<;
MONTH DAY
17<;QO
YES ~ NO
/lQ70
YEAR
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4. EMPLOYMENT
A. USUAL OCCUPATION Sl'!rvi c.e Tl'!c.hni c. i an
B. TYPE OF INDUSTRY OR BUSINESS HI" 1 1 At: 1 -"In t:; ('
5. PLACE OF BIRTH Bronx. New York
(CITY, STATE/COUNTRY IF NOT USA)
11. A. FULL NAME
Tinam-"lrip.
FIRST MIDDLE
n'Orazio
CURRENT SURNAME
6. FATHER
A. NAME Peter J. Sassano
B. COUNTRY OF BIRTH USA
7. MOTHER
A MAIDEN NAME Frances Ugliarolo
B. COUNTRY OF BIRTH TJ~A
8. NUMBER OF THIS MARRIAGE Second
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVil ANNULMENT
OnF!
DEATH
B. BIRTH NAME ,MAIDEN NAME). IF DIFFERENT
C. SURNAME AFTER MARRIAGE ~ a R R::I n 0
(OPT1ONAL . SEE REVERSE)
D SOCIAL SECURITY NUMBER 089- 'iO- ') 'i08
12. RESIDENCE A ~~ft) York B. ,J6lJN~hp.RR
C. CHECK ONE 0 CITY ~ TOWN C VilLAGE
AND
SPECIFY Wappinger
D. STREET ADDRESS t.. T.Jh; t:P (;::1 t: I" Rn Apt: T ZIP 1 ? <;QO
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VilLAGE? 0 YES ~ NO
13.A. AGE ?Q 13.B.DATEOFBIRTH Spnr /73 /1970
iIiONTH DAY YEAR
14. EMPLOYMENT
A. USUAL OCCUPATION Bank Teller Manager
B. TYPE OF INDUSTRY OR BUSINESS Unemoloyed
15. PLACE OF BIRTH Bronx. New York
(CITY, STATE/COUNTRY IF NOT USA)
16. FATHER
A. NAME Pet:er M. n' Orazi 0 Jr.
B. COUNTRY OF BIRTH USA
17. MOTHER
A. MAIDEN NAME
.Toann Vitagli::lno
1ST
2ND
3RD
4TH
I. being duly sworn, depose and say,
as to my right to enter into the mar'
21. SIGNATURE OF GROOM ~
B. COUNTRY OF BIRTH USA
18. NUMBER OF THIS MARRIAGE First
19; PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVil ANNULMENT
DEATH
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{ SEAL }
'-.,-I
SIGNATURE
MAILING ADDR
PO Box
B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE
C. DATE '-AST MARRIAGE ENDED?
31 ::: ANNULMENT
/ /
(2) ::: DEATH
YEAR
MONTH DAY
D. ARE ANY FORMER SPOUSEIS) ALIVE? ::J YES ::: NO
20. IF PREVIOUSLY DIVORCED OR ANNUlED. PROVIDE THE FOLLOWING INFORMATION
DATE OF DECREE PLACE ISSUED AGAINST WHOM
(MONTH. JAY. YEAR) ICITY, STATE/COUNTRY. IF NOT USAI SELF SPOUSE
Deputy Town
o
York Domestic
25. B. SOLEMNIZATION PERIOD
ENOS AT MIDNIGHT ON:
TIME
MONTH
DAY
YEAR
MONTH
DAY
YEAR
P
. AM
1:50 PM
07
27
00
09 24
28. PLACE WHERE MARRIAGE OCCURRED
00
i CERTIFY THAT I SOLEMNIZED
THE MARRIAGE OF THE PER.
SONS NAMED ABOVE ON THE
DATE AND AT THE TIME AND
PLACE INDICA TED.
A
27. TY~ OF CEREMONY
o VRELlGIOUS
9 C OTHER. SPECIFY
1 = CIVil
A. STATE NEW YORK B. COUNTY~"1'~
C. lOCATION OF CEREMONY
(CHECK ONE AND SPECIFY)
o CITY OF ~NOF L
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o 30. WITNESS TO CER Y ~
NAME (PRINT)
SlGNATURE~
DClH-9ll (11981
VilLAGE OF
NAME (PRINT)
SIGNATURE ~