Vail, Charles Form 4 V.S. THE LEGAL FEE FOR THIS PERMIT IS 50 CENTS Reg.-21
Dec 59 , iy w,cy 0
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STATE OF NEW JERSEY BURIAL OR REMOVAL PERMIT ,s i
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Ocean City, N.J . January P, , 19_ 43 ;.y`&.; ;4
(City, borough or township and date) y o
The Certificate of death having been filed with me, as required by the laws of this State, permission '°'R'
is hereby given for the removal, burial, or other final disposition of the body of Charles H. m
Vail , D.O. •
age 7 ' , sex , who died in Ocean City on_J a n. , r, 5
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Coonar Occlusion 0agoao
Cause of Death_ Y
Proposed Place of Removal, Burial or 1D ga E✓5
other Final Disposition Pine View Cemetery Glens Falls, N .Y. ID o oi o,
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Place Location
Funer D'rector E1 c''o 2,w
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9 Central Ave u AC r? - 8 y g E
Ocean City, N.J . `D ° , o0
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(Address) (Registrar of Vital Statistics) "�''m`"'
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PENALTY FOR BURYING WITHOUT A PERMIT, $5 to $100
STATE OF NEW JERSEY
BURIAL OR REMOVAL PERMIT
Name of Deceased
L� �� C l
ate of Buries or other Final Disposition
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--7gnature of Superintendent of Cemetery or Crematorium
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This permit must be delivered to the superintendent of
the cemetery or crematorium where burial or cremation is
to take place, who should 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.