Dion, Marcel Form 4 V.S. The Legal Fee For This Permit Is $1.00 Reg.21
Dec 61
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STATE OF NEW JERSEY BURIAL OR REMOVAL PERMIT : a•-`<'
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(City,borough or township and date)
The Certificate of Death having been filed with me, as required by the laws of this State, permission is hereby
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given for the oval, burial, or other final disks tion of the body of 2..9.!
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age.Z2_,7__, sex__d1:1-*, who died in ..._. .--.1-1=077-' ' on ..--- --4 ". -k ,I94:> :::.r....s ....
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Proposed Place of Remov$1._:.:ggl or , . Xs, g-. rl't
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(Address) (Registrar of Vital Statistic )
Penalty Forlarying Without a Permit, $5 to $100
STATE OF NEW JERSEY
BURIAL OR REMOVAL PERMIT
(Name of Deceased)
ate of or other Final Disposition)
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(Signature of Superintendent of Cemetery or Crematorium)
This permit must be delivered to the superintef4ent of the
cemetery or crematorium where burial or cremation is to take
place, who should fill in the spaces above and forwaril,it within
ten day-s to the registrar of the district in which the cemetery 0A.
crematorium is located. Registrars are usually health officers,
city and borough clerks and assessors of townships,'
When burial takes place in a cemetery which has no person
in charge, the spaces above should be filled in by the funeral
director, who should write "no person in charge" on the line for
signature of superintendent of cemetery and file the permit with
the registrar of the district in which the cemetery is located. The
law requires that this be done within ten days after burial.