Branson, Joan PERMIT FOR DISPOSITION OF HUMAN REMAINS
NAME OF DECEDENT SEX DATE OF BIRTH rouMUDDEATH
Jean Elizabeth Branson Female Apr. 19 1953 July 7 1980
PLACE OF DEATH—CITY OR TOWN PLACE OF DEATH—COUNTY (OR STATE IF NOT IN CALIFORNIA) NAME AND ADDRESS OF SPOUSE OR OTHER INFORMANT
El Cajon San Diego Peter S. Branson - Father
NAME OF FUNERAL DIRECTOR (OR PERSON ACTING AS SUCH) 1 CALIFORNIA LICENSE NUMBER
1 841 Singing Trails Dr,
Paris Mortuary 1 795 El Cajon, CA 92021
TYPE OF PERMIT. CHECK ONLY ONE OF THE FOLLOWING TYPES OF DISPOSITION
,mot CI 5. DISINTERMENT AND BURIAL (INCLUDES ❑8. DISINTERMENT AND REINTERMENT OF CREMATED
a
em I. BURIAL (INCLUDES ENTOMBMENT) ENTOMBMENT) REMAINS (INCLUDES INURNMENT)
�{L 2. CREMATION AND BURIAL (INCLUDES INURNMENT) El 6. DISINTERMENT. CREMATION. AND BURIAL
/❑3. CREMATION AND DISPOSITION OTHER THAN IN A (INCLUDES INURNMENT)
CEMETERY ❑7. DISINTERMENT. CREMATION. AND DISPOSITION ❑9. DISINTERMENT OF CREMATED REMAINS AND
❑4. SCIENTIFIC USE OTHER THAN IN A CEMETERY DISPOSITION OTHER THAN IN A CEMETERY
FOR THE PURPOSE OF ISSUING THIS PERMIT.DISINTERMENT IS DEFINED AS THE REMOVAL OF HUMAN REMAINS FROM ONE SPECIFIED PLACE OF DISPOSITION TO ANOTHER SPECIFIED PLACE
OF DISPOSITION. COMPLETE EACH ITEM REQUIRED FOR THE TYPE OF PERMIT SPECIFIED ABOVE AND INVALIDATE EACH LINE NOT REQUIRED FOR THE SPECIFIED DISPOSITION.
NAME AND ADDRESS OF CEMETERY WHERE REMAINS ARE TO BE INTERRED I COUNTY
BURIAL N/A
NAME AND.AnDRFGSLIF..CREMATIDRYWHFtB ISpFIraI'B6riFi IlTFF) DATE CREMATED_ -_SIGNATU _PFRSON IN_f 4EGE OF CRc_MATOPP.'._,.�
CREMATION Greenwood Crematory, San Diego,
PP``CA JUL 1 0 198t)► . .\Y1c
INTERMENT NAME AND ADDRESS OF CEMETERY WHERE REMAINS ARE TO BE INTERRED ) (COUNTY
AFTER CREMATION Seee Family Cemetery, Lake George, N. Y.)'-'-u�a�'S ��� 1
lM Warren
BURIAL AT SEA ADDRESV NEAREST POINT ON SHORELINE. OR OTHER DESCRIPTION SUFFICIE TO IDENTIFY FINAL PLACE AND COUNTY OF DISPOSITION
OR
DISPOSITION OTHER
THAN IN A CEMETERY N/A
OF CREMATED REMAINS
This is to certify that I am the person having the right to control the disposition of the SIGNATURE OF APPLICANT
ACKNOWLEDGMENT remains of the above named decedent under provisions of the Health and Safety Code, ►
OF APPLICANT and I herebyacknowledge that trespass andnuisancelaws apply and understand that DATE SIGNED
this permit gives no right of unrestricted access to property not owned by me.
SCIENTIFIC NAME AND ADDRESS OF FACILITY RECEIVING REMAINS
USE N/A
THIS PERMIT IS ISSUED IN ACCORDANCE WITH PROVISIONS OF AMOUNT OF FEE PAID DA R T S'-�(�x,` SIGNATU:E OF LOC, GIS R ISSUING PE M LOCAL ///{�/
REGISTRAR THE CALIFORNIA HEALTH AND SAFETY CODE AND IS THE . ,v7Vo► • i i/ + /'
AUTHORITY FOR THE DISPOSITION SPECIFIED IN THIS PERMIT
CERTIFICATION ;j J /],/ �� SIGNATUit eRS^ IN 1p�'yA,,RGE OF DISPOSITION
OF PERSON IN CHARGE I CERTIFY THAT THE SPECIFIED DISPOSITION WAS MADE ON �!! a . ► /n ��//
OF DISPOSITION ENTER DATE) �(/l� P
COPY 1 OF THE PERMIT ACCOMPANIES THE REMAINS TO THE STATED PLACE OF DISPOSITION. THE PERSON IN CHARGE OF DISPOSITION IS RESPONSIBLE FOR COMPLETING THE PERMIT AND FORWARDING THE COM-
PLETED PERMIT WITHIN 10 DAYS TO THE LOCAL REGISTRAR OF THE DISTRICT IN WHICH DISPOSITION OCCURRED OR TO THE LOCAL REGISTRAR OF THE DISTRICT NEAREST THE POINT WHERE THE CREMATED RE-
MAINS WERE BURIED AT SEA.
COPY 1 STATE OF CALIFORNIA—DEPARTMENT OF HEALTH SERVICES—OFFICE OF THE STATE REGISTRAR OF VITAL STATISTICS (REV. 5-78) FORM VS-9
(".
SPEC Ff,, ,TRUCT TO LOCAL REGISTRAR
AL/L
f/Ct,
'The Afolisowing sh,,ifuton, provisions nos oispahtsdicle io Ole dispos:irion --ket
inn-a ,titthe-i than in rni and id niial 5
isftri,tddinr, onothdind Hea:th dsid Sofetv Cade dpctions 705,1sfi„
d
riss,iihn cdni,nid diddasihon, Sisdeiy Cochst.
Sedions 7 00 dna 10376,5„;
/
r-,
2, (..,'nethinted remains must procdssed so hfpnt 'ihey suitab!e for
inurnment. tlealth. aria ,Oicifety Code Section 2054,1„)
„flididasss„ ficiarest point c descriptiari shfficieni ths,i •
ideniify finoi placts, and inaiihriti of disposition must be gi\ohn,
rid Saiisity Code Sechons I71 17, 10375 10376,5.)
4, ilhsi condihnins of the this.position mihst be keeping with pubik, sensi-
bilthes and fecni;onable chisitranise must be given that the disposiision
inni! inof cinfiled ant in accord:mice with the pridscribed conditions clod
„nit „or rpivofp or rW@Ine€:% l:HeCkh
Code Section 10376(c).)
5, Aophcis,:ro, cornisk„,te cicir,inuedgment that trespass and
noi,cnce opp:y to such disposition mathat ffiln permit dives
no fight of itirionftYiricied °chess to property not own,.',,d, h Apokthi„
H. recomrnended that ,,,vhen disposition f ma be made on property
not owned by the opplicard tim thi; is-JO-ten consent of the asivher
be oLdained. (Health arid Soktty Code Section ii(r76.5.)