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049 STATE OF NEW YORK r STATE FILE NUMBER I (THIS SPACE FOR STATE USE CWLt') COUNl'Y Dutchess DEPARTMENT OF HEALTH ~lltYfTOWN Wappinger ~ fJ /1.<i/bV DISTRICT,. 1168 AFFIDA VIT, LICENSE and NUMBER REGISTER 49 CERTIFICATE OF NUMBER MARRIAGE Lo SUPPLEMENTAL FILE ~ FROM THE GROOM FROM THE 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 of a second or subsequent ceremon . ~ 24. TOWN OR CITY CLERK 25. A. SOLEMNIZATION PERIOD BEGINS } NAME(PRINl1~~ H ~ ~own c~ {SEAL SIGNATURE ~ , I ~ J t DATE 5/2 / 00 MAILING ADDRESS '-v-' '-' ~ u u:: ;: II: W U w II: w r ;: m m w II: o o <( ~ ,.. u w a. m I- Z W m w III o ..J :::> o r m z o ;: ~ ?- m a w a: w ~ <( 'i: ~:i:<:! W :::>t::Q I;j;:~ ~ i!1 ~ ~i~ ii: i~ ~ ...-e~ w ...~ 0 i~; o 1ST o 2ND o 3RD CJ 0 4TH L! u owledge and belief that the information I provided is true and t at I declare that no legal ImpedIment eXIsts / '~ // ~ '- /~ 22. SIGNATURE OF BRIDE ~ L- i t://k-''f! C'r.:..//; us CURRENT NAME Town Clerk 1. A, FULL NAME MSlt"t"hpw P FIRST MIDDLE RSlnSll1n CURRENT SURNAME 11. N B, BIRTH NAME. IF DIFFERENT C, SURNAME AFTER MARRIAGE (OPTIONAL. SEE REVERSE) D, SOCIAL SECURITY NUMBER 0 R 0- 7 7 - F. 711 2. RESIDENCE A. (sf~/i)w York B, (cg~~chess c, CHECK ONE :J CITY ex TOWN 0 VILLAGE AND SPECIFY Wappinger D, STREET ADDRESS 4 Hiview Rd ZIP 121)90 E. IS RESIDENCE WITHiN UMITS OF CITY OR INCORPORATED VILLAGE? 0 YES IS NO 3. A, AGE 2 I) 3B. DATE OF BIRTH npC' /07 /1 q 7 ~ MONTH DAY YEAR 4, EMPLOYMENT W I- ~ <Jl A. USUAL OCCUPATION Sales Represeni tive B. TYPE OF INDUSTRY OR BUSINESS R;:l cH 0 ~h;:l C' k 5. PLACEOFBIRTH Cold ~nrinp.._NE!w York ICITY. STATElCOUNmy IF Nai"USA) 6. FATHER A. NAME Richard M. Ranallo B. COUNTRY OF BIRTH IJSA 7, MOTHER A. MAIDEN NAME Gloria A. Benedetto B, COUNTRY OF BIRTH USA B, NUMBER OF THIS MARRIAGE Fir ~ t" 9. PREVIOUS MARRIAGES A, NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY DIVORCE CIVIL ANNULMENT DEATH B. HOW DID LAST MARRIAGE END? (3) 0 DIVORCE C, DATE LAST MARRIAGE ENDED? (3) 0 ANNULMENT / / (2) 0 DEATH 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 1ST 2ND 3RD 4TH I. being duly sworn, depose and say, that t as to my right to enter into the marriag t 21, SIGNATURE OF GROOM ~ u w en z w o :::i 11, A. FULl NAME r.SI rn 1 FIRST Vill",hol CURRENT SURNAME T MIDDLE B. BIRTH NAME (MAIDEN NAME), IF DIFFERENT C, SURNAME AFTER MARRIAGE Ranallo (OPTIONAL. SEE REVERSE) D, SOCIAL SECURITY NUMBER 1 79- 7 !J.- P. F. 7 7 12. RESlDENCEA. New York B, nutchess iiTATm (COONT'Yj C, CHECK ONE 0 CITYJ(] TOWN 0 VILLAGE AND SPECIFY W;:lppi n gE!r 0, STREET ADDRESS 4 HiviE!w Rd ZIP I21)QO E. IS RESIDENCE WITHIN LIMITS OF CITY OR INCORPORATED VILLAGE? 0 YES iXI NO 13.A. AGE 77 13.B.DATEOFBIRTH !=;pnf"TH /17 /lQ7? Mi5N' DAY YEAR 14. EMPLOYMENT A. USUAL OCCUPATION Homem;:l kE! r B. TYPE OF INDUSTRY OR BUSINESS nnpmp 1 nyprl 15. PLACE OF BIRTH 011ppn,,_ Npw Ynrk (CITY. 'STAfEiCOOjijfRY IF NOT USA) 16. FATHER A. NAME .Joseph A. Villahol .Jr. B, COUNTRY OF BIRTH IT~A 17, MOTHER A. MAIDEN NAME Arlene n. Bell B. COUNTRY OF BIRTH IT ~ A 18, NUMBER OF THIS MARRIAGE ~..,.. nn rl 19. PREVIOUS MARRIAGES A. NUMBER OF PREVIOUS MARRIAGES WHICH ENDED BY DIVORCE CIVIL ANNULMENT Onp DEATH B. HOW DID lAST MARRIAGE END? (3) IX DIVORCE (3) 0 ANNULMENT ,21 C DEATH C, DATE LAST MARRIAGE ENDED? TunE' / 17 /1 QQ9 MONTH DAY ye.(R D, ARE ANY FORMER SPOUSE(S) ALIVE? Xl YES 0 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 6/17/99 NY Co. New York ~ DATE by New York Domestic 25. B. SOlEMNIZATION PERIOD ENOS AT II1DNIGHT ON: TIME MONTH DAY YEAR MONTH DAY YEAR AM 2:45PM 05 03 00 07 01 00 28. PLACE WHERE MARRIAGE OCCURRED A. STATE NEW YORK B. COUNTY )\.~ C. LOCATION OF CEREMONY (CHECK ONE AND SPECIFY) ~GE OF ;,