On August 10, 2023 a
Party Statement
was filed
involving a dispute between
Richard Todd Bennett,
and
None,
for Special Proceedings - Other (Finding of Fact)
in the District Court of Madison County.
Preview
FILED: MADISON COUNTY CLERK 08/10/2023 03:32 PM INDEX NO. EF2023-1619
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 08/10/2023
Exhibit D
Petitioner’s Redacted New York State
Birth Certificate
INDEX NO. EF2023-1619
RECEIVED NYSCEF: 08/10/2023
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NYSCEF DOC. NO. 5
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FILED: MADISON COUNTY CLERK 08/10/2023 03:32 PM INDEX NO. EF2023-1619
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 08/10/2023
rilililil illil ill]ilIillillltillt ililt lliltilltllil
*NY3575484*
r tlpr. 09/2020
This is to certi,fu that the wthin copy has been compared
by me with the original thereof on file in the Bureau of Vital
Records, l'lew York State Department of Health, AIbany, Ny
and that it is a correct copy of the original record and of the
whole thereof.
UnVAr- c bau,uz
New York State Registrar
rf,4fi
Ursula E. Bauer
0 &aj
N. B. Do not accept this copy unless the raised seal of the
New York State Department of Health is affixed, thereon.
AIbany, New York
Category
Special Proceedings - Other (Finding of Fact)
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Preview
FILED: MADISON COUNTY CLERK 08/10/2023 03:32 PM INDEX NO. EF2023-1619 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 08/10/2023 Exhibit D Petitioner’s Redacted New York State Birth Certificate INDEX NO. EF2023-1619 RECEIVED NYSCEF: 08/10/2023 trl 2 \ g t a. u lf\ E @ c3 t_ f rr o L () 2 l u o o \ !-l E3 o z E U I F U o I !- : t o tr. o t F F^ a d : o\ \c} E 6 I o> ztE F z E-t o (n h] o o [l F E L2 -= Fr o F t o o o E z td o o\ L o E-. ic) -u ? E F id Fi frl :l >t F t'c\ () (/) o a F L] 2 tr) t.{ z l H a z o a a U IJ H i D 'l\1 I F J u, L G I q o U \$ F tr o 0 o- _o U F l- oE o o Zp ) C! E _vt .q J U FILED: MADISON COUNTY CLERK 08/10/2023 03:32 PM r-< I { c; o fq I F o :H LlU rl Er g'u ; lrl 2,,:..::::,: Li : E: FL I o:.::, o o o t.,' o ;ts ::. o JU U:.: E{ o (9 E{ g& t F U ol t{ o.u Flt'l frl =2 H (f F o 4 a\ frl 2 z7 o) td a f{ z, (t) IU ts 7 9cf U c F tr] F t q frl Et' F{ ra 6ll,J cr) ;ul ,2 E e Fr o g, a o oo u ;E FF .i : q ?: A a F J a E-l o z E d t g u z a E F.l e E L L a L) o 2 tr, 4 I?] L o g l, I u ,(f) o F. trl 4 F cu U u U F )E Fl F B U C) x Fl F o 6 r! F H @ () l+1 F u J lrl F U a. d E F o H tl o F C o a O l-r 4 4 z F o g d o o t a4 d d td < o u o o fr] o U at d; = r) |o * < o 6 NYSCEF DOC. NO. 5 :x .Y E flo o ET t tr !J Fr2 zi *o ) td [, I Gr oF tr'L Y A I i ; ;*-ir -;tzo) ui ro U l, U o-fi uZ lu Fa d 6 FILED: MADISON COUNTY CLERK 08/10/2023 03:32 PM INDEX NO. EF2023-1619 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 08/10/2023 rilililil illil ill]ilIillillltillt ililt lliltilltllil *NY3575484* r tlpr. 09/2020 This is to certi,fu that the wthin copy has been compared by me with the original thereof on file in the Bureau of Vital Records, l'lew York State Department of Health, AIbany, Ny and that it is a correct copy of the original record and of the whole thereof. UnVAr- c bau,uz New York State Registrar rf,4fi Ursula E. Bauer 0 &aj N. B. Do not accept this copy unless the raised seal of the New York State Department of Health is affixed, thereon. AIbany, New York