Huth, Elizabeth FLORIDA STATE BOARD OF HEALTH /
Bureau of Vital Statistics Permit No S�
PERMIT FOR DISINTERMENT, TRANSPORTATION, AND REINTERMENT
Name of deceased Elizabeth Huth
Age 78 Race White Sex Femal e Date of Death Feb. 19, 1970
Place of original burial Mathews Funeral Home Vault St. Pete,„ Fla,
(Cemetery) (Address)
Glen Falls New York
Place of reinterment Pi View -Oet�3, t
(Cemetery) -- (Address)
Funeral director disinterring Norman Doherty 838
(Name) (License No.)
Permission is hereby granted to disinter, transport, and reinter the body described above subject to the regulations on the reverse
side of this forma�� .•Date Permit Issued cfc C 1 Signed:_ : ..��5 , 4 4, ��91 Registrar
Reg. Dist. No. ‘A Address _ ��% oo&5 ":: C ,4/ +.s ti 21-& '/ .
Endorse e t of/agent of cemetery fro whi remai are to `isinterred:
Date 7 7� «=v � u` 4�'� `�'"� (- '( �C� ��'-'
Cemetery Agent
Endorsement of agent of cetery m
in/whip
remains were reinterred:
Date 1 .` 1 //P -z.c.,�'--t-Ct-f --, 6-7
Cemetery Agent
This permit must be surrendered by the funeral director to the cemetery where re' terment i made. THE AGENT O THE
CEMETERY (OR THE FUNERAL DIRECTOR IF THERE IS NO AGENT) MU T FORW D THIS PERMIT WITHIN 10
DAYS TO THE LOCAL REGISTRAR OF HIS DISTRICT.
FORM V.5 #643 (Over)
INSTRUCTIONS - READ CAREFULLY
This PERMIT does not by itself entitle the holder thereof to the right to disinter the body. Permis-
sion to do so must be obtained from the next of kin of the deceased or the proper legal authority. In
cases where an autopsy is to be performed, permission must be obtained from the next of kin or other
proper legal authority.
The purpose of this permit is to certify that the Local Registrar has been notified of the intention to
disinter and to provide authority for reinterment of the body.
This permit is authorization for transportation of the body by common carrier or otherwise. No addi-
tional permit is required for this purpose.
When a second funeral director is to reinter the body, his name should be added to the front side of
the permit below the name of the funeral director who disinterred.