Dory, Lattie corm 4 V.S. The Legal Fee For This Permit Is $1.00 Reg.21
Dec.61 n ry
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STATE OF NEW JERSEY BURIAL OR REMOVAL PERMIT =. w b*
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(City,borough or township and
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The Certificate of Death having been filed with me, as required by the laws of this State, permission is hereby tr.' rn
given for the removal, burial, or r final disposition of the body of °.%'q
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age___ sex__ ____:__, Zn—__ on ___,19—
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Cause of Death — ``' __ ] 7
Proposed Place of Removal, B or ,i �� h
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other Final Disposition __ - _ �� g a
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(Address) (Registrar of Vital Statistics) * x9
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Penalty For Burying Without a Permit, $5 to $100 " °-'.1
STATE OF NEW JERSEY
BURIAL OR REMOVAL PERMIT
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(Name of Deceased)
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(Date ,j Burial or other Final Disposition)
(Signature of Superintendent of Cemetery or Crematorium)
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 forward 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.