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USE
23. SUBSCRIBED AND SWORN TO/AFFIRMED BEFORE ME 1 0/08/201 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
{ } NAME (PRINT) Joh C. Mast
TIME MONTH YEAR MONTH DAY
SEAL SIGNATURE ~ DATE 10/08/201
MAILING ADDRE~S AM
'-v-I 20 Midaleb ers Falls NY 12590 03:07PM 10
STREET ST ATE
I CERTIFY THAT I SOLEMNIZED 27. TYPE OF CEREMONY
THE MARRIAGE OF THE PER.
SONS NAMED ABOVE ON THE 0 0 RELIGIOUS
DATE AND AT THE TIME AND
PLACE INDICATED. 90 OTHER, SPECIFY
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STATE OF NEW YORK
DEPARTMENT OF HEALTH
AFFIDAVIT, LICENSE and
CERTIFICATE OF
MARRIAGE
FROM THE GROOM
Ten~g&~ HlIgh '^f:l?R~~~SURNAME
COUNTY Dutchess
CITYrrOWN Wappinger
~~~:f: 1368 .
~~~I~J~R 142
1. A. FULL NAME
FIRST
B. BIRTH NAME, IF 01 FFERENT
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE)
D. SOCIAL SECURITY NUMBER 11 ~-~4-R~ 1 ~
2. RESIDENCE A. N"TATE) B. ~ess
C. CHECK ONE 0 CITY ~ TOWN 0 VILLAGE
AND W .
SPECIFY ::IrrtngAr
D STREET ADDRESS 10 Edgehill Dr ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES!'J NO
3. A. AGE 45 3B. DATE OF BIRTH MO~~ / Dlp / Yt~65
4. EMPLOYMENT
A. USUAL OCCUPATION Operator
B. TYPE OF INDUSTRY OR BUSINESS Indi::m Point
5. PLACE OF BIRTH YnnkAr!=: NAw York
(CITY, STATE I CbUNTRY IF NOT USA)
6. FATHER
A. NAME Harold Leo Woods
B. COUNTRY OF BIRTH l J ~ A
7. MOTHER
A. MAIDEN NAME norothy Ro!=:e M~C~lIen
B. COUNTRY OF BIRTH l J ~ A
8. NUMBER OF THIS MARRIAGE 2
9. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
B. HOW DID LAST MARRIAGE ENO? (3) r1 DIVORCE (3) 0 ANNULMENT
C. DATE LAST MARRIAGE ENDED? OR/ 09 /
MONTH DAY
D. ARE ANY FORMER SPOUSE(S) ALIVE? ~ES 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
08/09/2006 Poughkeepsie. New York ~
DEATH
o
(2) 0 DEATH
2006
YEAR
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29. OFFICIANT
NAME (PRINT)
NAME (PRINT)
SIGNATURE~
DOH-B8 (09/2009)
I
STATE FILE NUMBER
(THIS SPACE FOR STA TE USE ONL Y)
'I
L 0 SUPPLEMENTAL FILE
FROM THE BRIDE
~
Nenita Honga\la Woods
FIRST MIDDLE T CURRENT SURNAME
B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT Mn!=:l::Irp.!=:
11. A. FULL NAME
C. SURNAME AFTER MARRIAGE
(OPTIONAL - SEE REVERSE) 593 90 1 057
D. SOCIAL SECURITY NUMBER ___ - _ -
12. RESIDENCE A. NY B. Dutchess
(STATE) (COUNTY)
C. CHECK ONE 0 CITY I!"l TOWN 0 VILLAGE
AND W .
SPECIFY applnger
D. STREET ADDRESS 1 0 Edgehill Dr ZIP 12590
E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES ~ NO
Ala /f 966
DAY YEAR
13. A. AGE 4~
13B.DATE OF BIRTH
11
MONTH
14. EMPLOYMENT
A. USUAL OCCUPATION Housewife
B. TYPE OF INDUSTRY OR BUSINESS Housewife
15. PLACE OF BIRTH Mabalacat. Philippines
(CITY, STATE / COUNTRY IF NOT USA)
16. FATHER
A. NAME Am~ndo Moslares
'B. COUNTRY OF BIRTH Philippines
17. MOTHER
A. MAIDEN NAME Marciana Hongaya
B. COUNTRY OF BIRTH Philippines
18. NUMBER OF THIS MARRIAGE 2
19. PREVIOUS MARRIAGES
A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY
DIVORCE CIVIL ANNULMENT
1 0
B. HOW DID LAST MARRIAGE END? (3) c!' DIVORCE (3) 0 ANNULMENT (2) 0 DEATH
C. DATE LAST MARRIAGE ENDED? 08 / 09 / 2006
MONTH DAY - YEAR
D. ARE ANY FORMER SPOUSE(S) ALIVE? [!'YES 0 NO
DEATH
o
o
o
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
1ST 08/09/2006 Pouahkeepsie, New York d
~D 0
~D 0
25. B. SOLEMNIZATION PERIOD
ENDS AT MIDNIGHT ON,
YEAR
09
07 2010
2010
12
ZIP
1 rsfclVIL
28. PLACE WHERE MARRIAGE OCCURRED
A. STATE NEW YORK B. COUNTY \)A\-a~
C. LOCATION OF CEREMONY
(CHECK ONE AND SPECIFY) /
o CITY OF 0 TOWN OF ~ VILLAGE OF
SPECIFY \AI Is
NAME (PRINT)
SIGNATURE~