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Lockhart, George 109/29/2011 11:01 8178841075 TARRANT COUNTY VITAL PAGE 01/01 ;s En . '`�� `-* ,r;: BURIAL-TRANSIT PERMIT o Nama al D coa0ad-Flmt Middle Lam I. ; GEORGE _ LOCKHART 5 Aga Sax Dam of Dnath b nthod of D r.pana -- ' —-- i �i 54 El Male ❑Female 09/25/20 1 1 0 Removal ❑ Cremation D Burial ' o gt PIPce or D9PN City County State € SOUTHLAKE TARRANT TX D 'C co Nnm r+m w of Cn(wry or Oranwtpdt,m City Vail? i PINE VIEW W CEMETERY QUEENSBLRY NY C PrInf-Ne,,a qt Fsinerel ralreClor or Pereon Rgtfn9 ea 590 Adtlraw City State Zip Code e MARTIN JOSEPH THOMPSON#8257 523 S. MAiN STREET, GRAPEVINE TX 76051 c 2 "lF-; ,farm. .i RaiVrer __. _ County ' Cit1 IN D'recinot _. - _ —-bile NurY�af --- ----- C MARY LOUISE GARCIA TARRANT COUNTY CLERK 1660 g A certificate of death having been registered or completed in so far as possible; permission is hereby '1-° ' given for final disposition,transport,or removal of the body from the state of Texas. CO 2 g l t9.4'-J` Gc .r _m 09/29/2011 - - JS9nPture of Replatrer or Eleclrc n c Variation Data A G f 0. a - N \ a Receive I • / , �//�Qta Date 97 / m / e fti e Vital Statistics 25 Texas Administrative Code Soc. 181.2(b)"If a dead body or fetus is to be removed from this state,transported by common 2,, carrier within this state,or cremated,the funeral director.or person acting z s such,shall obtain a burial-transit permit from the local registrar m where the death certificate is or will be filed,or from the state registrar electronically through a Bureau of Vital Statistics electronic death to registration system,The registrar shall not issue a burial-transit permit until a certificate of death,completed in so far as possible,has been presented." 0 • A file number may be assigned by the Registrar as needed. A copy of this permit is to accompany the body in tn• transit.There is no fee authorized for the issuance of a Burial-Transit Permit. 2 m If an incomplete death certificate is used to obtain the Burial-Transit Permit, the registrar will validate that the body I- is no longer needed by the certifier of cause of death before issuing the permit, to ensure that a completed death d certificate will be received. "Completed in so far as possible" means_the information_relating to the-deceased, - E including the name, date of death, place of death and ftneral director's information is completed. in a few g instances, the cause of death may not be completed. It Is the responsibility of the person presenting the '= Certificate of Death, and obtaining the Burial-Transit Permit, tp assure that the fully completed Certificate of Death is filed as soon as possible. E E In accordance with state Statute, before a dead body can be cremated, a Cremation Authorization must be signed o and issued by the medical examiner or justice of the peace of the county in which the death occurred showing at that an autopsy was performed or that no autopsy was necessary. If an inquest is being conducted by the N medical examiner or justice of the peace, authorization for cremation from the medical examiner or justice of the peace is required. .o t- 6 [I-15C§193.008,25 TAC§181.2,§181.31 Z_ Z CC • VS-tie Revised 9/2004