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Rendace, William A.
t. Mlz NEW WIRRSTATE DEPARTMENT OF HEATH h . Burial- Transit Perml Bureau MVifal Records Ftd�Uly"7F Film Middle IanEe"MebA Rerbt'alry Ig HVMan AUSNeal Fwa4x nr.we w.orode. eae vesReM tbSPilallnsNutimanm Vi BMm Tom ArtHMdrtss 11 AVYMLare.Bdlm Tcwn, Nw YM 1]Ht<of Deah ®Named call" ❑ACCEm ❑HBmoN ❑N kae � mm �PemimaN m nCMikr NameTRIeM'7mere:Nlasf.UreanWryTun.Xex YeM l3Ma SMNumklfamaree fied Gaektx^mlee :Wni rL it nlaM 0 B Burial Dare fanMery.CremMyw FailMHame ❑Fnbmbmem mdrewillmm reYan CianWwy ©Cremdon geenY�ay Tw'm.Nen Yak ❑Eaton e �Removal Data nova Removed md/or amNr&M Hold Address DIN Palma M ❑Tramsem Wn $ryi mem by Coarman Umer Demeanor; �Disimermenl Nit CenYAdimv �Pei0ermenl Date Cemelerymeress PermiJssuetlm wgrwun Number Name 01 Funeral Home Y'Na^der Dekr FwawlXome DDmT Address 009 MaIa m,Voaaenmuq.Nuw YaM1 40Be Nameol Fureol Flm.MaGng01spiilionorm Whom I_ kemainsare Ai d.HDtlrrrhan,Mr E Addmss w D' Perm ul n IN El gMW m Ulapose of me bumen mmelna dNdNadbW above Ot lfMkAbld. Dale Issued M11=20 Wv mr NY^al SmiNw 1�G CwrwNy J�OP ngmwel Bslael Numbr SLO Place 10I"I416,19 Nw"YM emry lhal�mnainsotlFedneeemidentinee abwewerteiapud Wi^aoaNaaa MdIlM'Pecpmnun: WOaleol pripshbn Q i Plxe of DlsFwVon �PWwl W mAy 4Mn1 pewd+y� $ NamemxaNnaeaeaP^in Cmteeal �,, a-»u! "'")w$ slgndnre Z, THE, WHl5551n1NIP,0f2 Rublie Heath Lave sec. al4s(zb) U 12703 Receipt Hwnan remains of � Rf J C� delivered oe 7' 1 �, - .. gey{uemldB lM NneN hmM o�ameLmb�YL t PIneY'�mia)' WmNOi�Mon 148.a Limn N � OMcial