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Kibling, Joann Marie
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Joanne Marie Kibling Female Date of Death Age If Veteran.of U.S.Armed Forces, 03/24/2020 53 Years War or Dates II.— Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Q Mannerof Death © Natural Cause Accident Homicide Suicide Undetermined Pending W Circumstances Investigation W Medical Certifier Name Title Rita All NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 139 ❑Burial Date Cemetery,Crematory or Facility Name 03/26/2020 Pine View Crematorium Entombment Address ®Cremation Queensbury Town,New York Donation Q❑Removal Date Place Removed and/or and/or Held ~ Hold Address 0 O d Date Point of Cl) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom F. Remains are Shipped,If Other than Above 2 Address cc W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/26/2020 Registrar of Vital Statistics &6ert gndrew Curtis(ECectronicaCCy Signed) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: WDate of Disposition 130170 Place of Disposition -- 2 (address) W N (section) (lot number) (grave number) cc ` 0 Name of Sexton or Person in Charge of P iises Z (please print W Signature Title DOH-1555(o7/18)p 1 of 2 Public Health Law Sec. 4145 2b y "1 Receipt Human remains of - _ delivered on , 20 Pine Vew Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# I