Abbott, Maud Form 4 V.S. THE LEGAL FEE FOR THIS PERMIT IS 50 CENTS Reg.-21
Dec 59
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STATE OF NEW JERSEY BURIAL OR REMOVAL PERMIT R'"-y
5'¢ `
Plainfield, N. J. December 3 62 o 0"
, 19 rr �q�:
(City, borough or township and date) n o co
The Certificate ofdeath havingbeen filed with me, as required the laws ofthis State, permission .-a a
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is herebygivenfor the removal, burial, or other final disposition of the bodyof 'a` ' E. ( 0.`D
F Plainfield, N.J. Dec. 1 " �*p 0 a
Abbott age , sex , who died in on a
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1962 CD
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Cause o f Death Shock & Hemorrhage - ruptured kidney,ruptured urinary bladder o g o a
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Proposed Place of Removal, Burial or `D m c
other Final Disposition_ Pine View Cemetery, Glen Falls, N. Y. o o o 0 0
Place Location �• -,-
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Funeral Director 5 "°, 5.
A.M.Runyon & Son,Romeo Baker, y�" o p
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900 Park Ave. Plainfield, N. J. e to®,-0 o,
(Address) ��4 (Registrar of Vital Station's %l /: a p""oa W fir`"•'
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PENALTY FOR BURYING WITHOUT A PERMIT, $5 to $100
STATE OF NEW JERSEY
BURIAL OR REMOVAL PERMIT
Name of Deceased
e .
Date
fnl
Burial or other Q anal Disposition
Signor of.Superint dent o em er or Crematorium
C2/ • 77-&111-4'..,14 tE41
This permit must be delivered to the superintendent of
the cemetery or crematorium where burial or cremation is
to take place, who shouhd fill in the spaces above and for-
ward it within ten days to the registrar of the district in
which the cemetery or 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.