Greenberg, Gertrude 'orm 4 V.S. The Legal Fee For This Permit Is *1.00 neg.21- --
Dec.61 c n 52 54*
c a..." :r
STATE OF NEW JERSEY BURIAL OR REMOVAL PERMIT 2.w n w n
OMERVILLE, N i; July 10, ,19 70 0 0 n 0
---- ----------
(City,borough or township and date) f° �,
The Certificate of Death having been filed with me, as required by the laws of this State, permission is hereby R m,e
given for the removal, burial, or other final disposition of the body of ».R": e
o e'
_ Get'trude' Greenberg an ., a
age._42..-._,sex-F , who died in_C z_e.n.,--__.LYa...,J._a on` July 9_., ,19---_7.0_. Rs
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..
a ,Pulmonar Embolism ao o
Cause of Death -----------•------------------ ________ a Proposed Place of Removal, Burial or ; "'n
other Final Disposition i?gray-T of i l a_C em.-_______•__-_ G ign s__F al l s , N. Y L—_ ;.n s
Place Location 4. r. n
Funeral Director el o,o
Norman R. Van Arsdale 2446 M
o . a
Somerville, N. J. °
(Address) (IIe5l.rar of Vital-Statistics) ._ N E 'I
Penalty For Burying Without a Permit, $5 to`S400..__- '. g a a1