Cunnion, Caroline Form 4 V.S. The Legal Fee For This Permit Is $1.00 Reg. 21
Dec. 61
STATE OF NEW JERSEY BURIAL OR REMOVAL PERMIT v F, a
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The Certificate of Death having been filed with me, as required by the laws of this State, permission is 4 o fi
hereby given for the t'emoval, burial, or other final disposition of the body of y g
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a e... .. ...., sex who died in a .�.W Y} ono? V 19.. ... ... 2 b. -y
Cause of Death }'..? .V. .... t. .`=.t m....t.t.�?. ,.r...f...H.k d.t�A L v°�x
Proposed Place of Removal, urialf or ,� i I v I- o
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other Final Disposition 0 7-' 11D N o11s�S.. k..R.'C...�...2-.1 e a:$...:..1:- ;.�.1�....1. H•y . .2 a,•r' 4
Place i - Location v c.1
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Funeral� Director 3 v v •
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(Address) (Registrar of.. ital Statistics) H 8" .
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Penalty For Burying Without a Permit, $5 to $100 0� 8
STATE OF NEW JERSEY
BURIAL OR REMOVAL PERMIT
1.4L►ym,19-N. .(,vim.
(Name of Deceased)
CrIN C. ),...%117 3 .t:n... .,..adephiVol Ce`t
(Date o Burial or other Final Disposition)�
Su S p to ' 1-�F # I •
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(Signature of Superintendent of Cemetery or Crematorium)
This permit must be delivered to the superinpepclent of
the cemetery or crematorium where burial or c'remation is to
take place, who should fill in the spaces'above and forward
it within ten days to the registrar of the district in which
the cemetery or crematorium is located. Registrar are usually
health officers, city and borough clerks apd assessors of
townships.
When burial takes places in a cemetery which has no
person in charge, the spaces above should be'filled in by
the funeral director, who should write "nd person in
charge" on the line for signature of superintendent of
cemetery and file the permit with the registrar of the dis-
trict in which the cemetery is located. The law requires
that this be done within ten days after burial.