SchneiderJr., John Karl NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
John Karl Schneider Jr. Male
Date of Death Age If Veteran of U.S.Armed Forces,
04/26/2020 87 Years War or Dates 1952-1954
II.- Place of Death Hospital,Institution or
WCity,Town or Village Amsterdam Town Street Address Capstone Center For Rehabilitation And Nursing
p Manner of Death Natural Cause Accident Homicide ❑Suicide Undetermined Pending
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C) Circumstances Investigation
QW Medical Certifier Name Title
Eyad Aldaas MD
Address
302 Swart Hill Rd,Amsterdam,New York 12010
Death Certificate Filed District Number Register Number
City,Town or Village Amsterdam 2850 56
Burial Date Cemetery,Crematory or Facility Name
04/28/2020 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
OZ Removal Date Place Removed
and/or and/or Held
~N Hold Address
O
d Date Point of
to Transportation
p by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
F. Remains are Shipped,If Other than Above
Address
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n' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/28/2020 Registrar of Vital Statistics Linda 0arton,-7fug&x(—EYectronicaf SrgnedJ
(signature)
District Number 2850 Place Amsterdam, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition 4/-Zy",---W ZO Place of Disposition
2 (address)
W
N
Ir (section) \ ) (!ot,7 ber) (grave number)
aName of Sexton or Person in C ge Premis
Z (please print)
W Signature Title L rg rt�rt��`avi e
DOH-1555(o7/18)p 1 of z
Public Health Law Sec. 4145(2b) -3 `
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#
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