Richards, Lynne NEW YORK STATE DEPARTMENT.
OF HEALTH Vital Records Section Burial - Transit Permit
:* Name First Middle Last Sex
. Lynne S. Richards Female
*�. Date of Death Age If Veteran of U.S. Armed Forces,
n: : December 27,2016 73 War or Dates
Place of Death Hospital, Institution or
City, Town or Village East Greenbush Street Address 80 Moore Road
dip.. Manner of Death g Natural Cause Accident Homicide Suicide Undetermined Pending
Si Circumstances Investigation
wi Medical Certifier Name Title
Dr.Garbo MD
t.: Address
400 Patroon Creek Blvd,Albany,NY
t: Death Certificate Filed District Number Register Number
°a City, Town or Village
❑Burial Date Cemetery or Crematory
❑Entombment December 29,2016 Pine View Crematory
Address
❑X Cremation 21 Quaker Rd., Queensbury,NY 12804
Date Place Removed
Z Removal and/or Held
2 and/or Address
F_ Hold
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O Date Point of
N I I Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
IReinterment Date Cemetery Address
IPermit Issued to Registration Number
;_ : Name of Funeral Home Alexander-Baker Funeral Home 00037
'_ Address
3809 Main Street,Warrensburg, NY 12885
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
z Address
tZ
ILI
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 1A Ide pQi(p Registrar of Vital Statistics ki(10tho
(signature)
District Number 91 Place T/O East Greenbush,NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
w Date of Disposition /Z/Z9//(9 Place of Disposition /?)Q i.,)I (� (address)!c?Me.le;y
2 /
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0 (section) / (lot number) (grave number)
p Name of Sexton or r in Charge of Premises � L.. /,o,v1 CX., e
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Signature Title G r -- -4:,/c9..
(over)
DOH-1555 (02/2004)