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Kots, Evelyn
NEW YONNSTATE DEFAFTMEXTCFHEALTH Burial - Transit Permit Bureau of vital Reveres Name Flrn Middle lust Emote jEEIbS ceA A nveceranaus Almee rma ozB s2 v.ere waror Rm. F once ol0x&n Hospital lnNlunm« 2 Cry.laem aVIderie en Fatl¢ 54eet MJress Gon¢Fdb rat c Manrerol oemer ©Natural Cum ❑ dem ❑ keo ❑AaiHomSukid annmdanaa e pwdersmimd �verr�n W mas W MMial Qrlifer Nam Th S o Sun No No laxecur 1 W Park In. &cWen¢Fal¢.Nmr Vo'F men Dead, Foa oimN Number Regi¢lerxnmxr c' rvu Cl... AIRFAI R sanl IDB Burial Dn` <xnerery.<remauryor ixi111y Name Cool�Entemement MaVkw Gmebry � ress Cremmiu pym AnWury Tpm,max YwA burden �flemwal lum none Named a,&r ava NeM Hole Address ElTmeeareem Ogle Poim of myComew M1i Gre,El cemnmon Denotement Dale Ce mmmyAdems, ❑IkmMmem Ox QmeknAdere¢e Poimilletedm xLynralonxuneer Nameol Fureral Home MBlelmw Fumna Home-SOMpvs FJ¢ 01W8 Address IN Mao 5L 5 em,Fatl,, Ne,Yoh 12803 men,off Funeral Fenn Mating Oisposnion or to Whom t At Is are 9lped,x other Ow,Nnw J Address 6 W u PxmisYen uM1alaby graM&tlbtllapeed of the M1umn ramaine ddeMM1atl abovaulntllcdlatl. One leaned MC52020 RagineofVio¢mmir, Remit Andrew Curtis(Eleolmnlrally Signed) GMxaey Ditt,014umnv 5601 Flxe Gon¢FYk, New Ym, I army Maeth renans M the Medemidenu ie l Wove were dunned of in xmre na,xith NN pram an! IN DaXo(Di¢posnon 7111202n PorrOOM1pmieon 71 Cornea, RM O ee 2 fermi On Oneida 126&131 2 art ffurewen lmaamwmi SNamenl5em rhmnincha Premix Connie Goederc 2 4x XkV W sRoaWrt `AIli Tile DOH-155001ABIP102 Nbpa Hebb law Sec 4145(2b) Receipt 010397 s Hwnav rumins of �! J ,, delivered on agw fl ; Yl dery om Nepra.n�ing 1M1ef a home name)on bowl Odieial Fonwel Dlmcbn kC. or Lireroc p pem�ii EMS Age: 92 'VW6 Evelyn E. KOte La Oxmtt: Evelyn Kota Gm u 2 tae Oneida 126 6 131 ce z macrete Need: )/1 /2020 6/24/2020 Fmeed Mame' M.B. Kilmer Cemeury: Pine View