Tompson, Anna NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit
Bureau of Biostatistics- Vital Records Section
Name First Middle Las. Sex
Date of Dea € Age If Veteran of . .Arme orces,
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0. Date Point of
(6 ❑Transportation by : Shipment
CommonCarrier .....................................................................................................................................................................................................
Destination
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❑ Disinterment Date Cemetery Address
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El Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Firm
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Remains are Shipped, If Other than Above
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Address
Permission Is hereby granted to dispose of the dead re ns escribe above as indicated.
I Date Issued 1- "7 Registrar of Vital Statistics
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District Number .5 e�D� Plac ,,,G,.� a - J0r ,�`
I certify that the remains of the decedent identified above were disposed of' ccordance with this permit on:
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W Signature t l Title
DOH -1555 (9/86)p 1 of 2(formerly VS-61)
PUBLIC HEALTH LAW
§4145. Deaths; burial and removal permits; disposition of remains.
1.No person in charge of any premises on which interments,cremations or other disposition of the body of a deceased person are made
shall inter or permit the interment or other disposition of any body unless it is accompaniedpy a burial,cremation or transit permit,as provided
in this article.
2.The funeral director or undertaker shall deliver the burial permit to the person in charge of the place of burial or other disposition,before
interring or otherwise disposing of the body;or shall attach the removal or transit permit to the box containing the body,when shipped by any
transportation company,which permit shall accompany the remains to its destination,where if within this state, it shall be delivered to the
person in charge of the place of burial or other disposition.
3.The person in charge of the place of burial or other disposition shall endorse upon the permit,the date of interment,or cremation or other
disposition over his signature, and shall return all permits so endorsed to the registrar of his district within seven days after the date of
interment, cremation or other disposition.
4.When burying or otherwise disposing of the body of a deceased person in a cemetery or burial place having no person in charge,the
funeral director or undertaker shall(a)sign the burial or removal permit,giving the date of burial;(b)write across the face of the permit the
words"No person in charge;"and(c)file the burial or removal permit within three days with the registrar of the district in which the cemetery is
located.
5.The person in charge of the place of burial,cremation,or other disposition shall keep a record of all bodies interred or otherwise disposed
of on the premises under his charge,in each case stating the name of each deceased person,place of death,date of burial or disposal,and
name and address of the funeral director or undertaker, which record shall at all times be open to official inspection.
DOH - 1555 (9/86)p 2 of 2 (formerly VS-61)