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Snyder, Marion NEW YORK STATE DEPARTMENT OF HEALT Vital Records Section Burial - Transit Permit Name First Middle Last Sex Marion Snyder Female Date of Death Age If Veteran of U.S.Armed Forces, 09/05/2017 69 Years War or Dates Place of Death Hospital, Institution or City, Town or Village Granville Village Street Address Indian River Rehabilitation And Nursing Center Manner of Death©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title Thomas Kandora MD Address 17 Madison St,Granville Village,New York 12832 Death Certificate Filed District Number Register Number City,Town or Village Granville Village 5725 23 El Burial Date Cemetery or Crematory 09/07/2017 Pine View Crematory El Entombment Address ®Cremation Queensbury Town, New York Date Place Removed ❑Removal Ind/or Held and/or Address Hold Date Point of ❑Transportation Shipment by Common Destination Carrier ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/07/2017 Registrar of Vital Statistics d*&as Edina ysipterf (signature) District Number 5725 Place Granville Village, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition I$'1) Place of Disposition 17;litLI tr-- (address) (section) liot number)r (grave number) Name of Sexton or Person in Charge Premises ,, J asWa�' �I (pl se print) Signature Title r �� �` (over) DOH-1555(02/2004)