Loading...
Steffin, William NEW YORK STATE DEPARTMENT OF HEALTH • S6( Vital Records Section Burial - Transit Permit Name First Middle Last Sex William F. Steffin Male Date of Death Age If Veteran of U.S. Armed Forces, November 8, 2016 87 War or Dates 1 C15 I -55 Place of Death Hospital, Institution or -bit;Town or Villagc Argyle • Street Address 198 Town Line Road L Manner of Death X❑Natural Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined El❑ Pending Circumstances Investigation Al Medical Certifier Name Title Thomas Coppens, Dr. Address 3 Iron Gate Center Glens Falls 12801 Death Certificate Filed • District Number S7So Register Number City, Town or Village Argyley7 ❑Burial Date Cemetery or Crematory November 9, 2016 Pine View Crematory ❑Entombment Address ©Cremation Quaker Road Queensbury,NY 12804 Date Place Removed z ❑ Removal and/or Held • and/or Address • Hold Date Point of 4.0 ❑Transportation Shipment • iet by Common Destination a Carrier Date Cemetery Address ❑ Disinterment ❑ Reintermnt Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M.B. Kilmer Funeral Home-SGF 01078 Address 136 Main Street, South Glens Falls NY 12803 Name of Funeral Firm Making Disposition or to Whom t, Remains are Shipped, If Other than Above • Address I a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11 -4r_ 14, Registrar of Vital Statistics SALMI /it.fj,,,fe_ (signature) District Number S1So Place CININtt hi I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 11/09/2016 Place of Disposition Quaker Road Queensbury,NY 12804 (address) iii 49 (section) (lot number) (grave number) O Name of Sexton or Person in Charge of Premises r rsicpIUr ,ice^nt it ((lease print LU Signature L°l Title itto IlittP_ (over) DOH-1555 (02/2004)