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Sherman, Lorraine June 44, NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last --FSex Lorraine June Sherman Female If Veteran of U.S.Armed Forces, Date of Death Age 04/30/2020 85 Years War or Dates �.. Place of Death Hospital,Institution or WCity,Town or Village Saratoga Springs Street Address Wesley Health Care Center Inc p Manner of Death F4711' Natural Cause Accident Homicide Suicide Undetermined Pending W Circumstances Investigation V W Medical Certifier Name Title Rick Teetz MD Address 131 Lawrence St,Saratoga Springs,New York 12866 Death Certificate Filed District Number Register Number City,Town or Village Saratoga Springs 4501 259 Burial Date Cemetery,Crematory or Facility Name 05/01/2020 Pine View Crematory Entombment Address FRICremation Queensbury Town,New York Donation © �Removal Date Place Removed and/or and/or Held l—N Hold Address 0 a. Date Point of to F1 Transportation p by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home ---701130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom f— Remains are Shipped,If Other than Above a Address cc Ili a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/01/2020 Registrar of Vital Statistics .7o67 Paul-!Franc( ySigned� /signature) District Number 4501 Place Saratoga Springs, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition ���1� Place of Disposition 1-LLLJ (address) W N Q (section) llot number) (grave number) Name of Sexton or Person in Charge of emises ^1 2 (plea print)W Signature Title C" o DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) y IJ 13 S 91 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# s