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Hoenigmann, Reinfried f � NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Reinfried Lorenz Hoenigmann Male Date of Death Age If Veteran of U.S.Armed Forces, 06/20/2017 95 Years War or Dates Place of Death Hospital, Institution or City, Town or Village Glens Falls Street Address The Pines At Glens Falls Center For Nursing&Rehabilitati Manner of Death©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title Gwendolyn Morris-Dickinson PA Address 170 Warren St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City, Town or Village Glens Falls 5601 343 ❑Burial Date Cemetery or Crematory 06/22/2017 Pine View Crematory ❑Entombment Address ®Cremation Queensbury, New York Date Place Removed ❑Removal and/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 Regan Denny Stafford Funeral Home 01443 Address 53 Quaker 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 06/22/2017 Registrar of Vital Statistics neg6ertACultic fElectronica/Cysigned (signature) District Number 5601 Place Glens Fails, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition /I3in Place of Disposition fir)tUst, gs,,,,rt2for,o— (address) (section) /�'�(lot number) (grave number) Name of Sexton or Person in Charge o Premises /At (' ,)t441It (p/ a print) Signature �" rrXl Title J IMit�l� (over) DOH-1555(02/2004)