Getz, Alfred -z64
NEW YORK STATE DEPARTMENT OF HFAI-T,;.,
Vital Records Section Burial - Transit Permit
;s. Name First Middle Last Sex
Alfred S. Getz Male
Date of Death Age If Veteran of U.S. Armed Forces,
April 6, 2016 87 War or Dates
Place of Death Hospital, Institution or
A . City, Town or Village Glens Falls Street Address Glens Falls Hospital
214 Manner of Death Natural Cause Accident Li Homicide ❑Suicide Undetermined Pending
111 Circumstances Investigation
w Medical Certifier Name Title
0. Aqueel Gillani Dr.
Address
102 Park Street,Glens Falls,NY 12801
Death Certificate Filed District Number Register
Register Number ���
City, Town or Village
❑Burial Date Cemetery or Crematory
April 7, 2016 Pine View Crematorium
❑Entombment Address
❑x Cremation 51 Quaker Road, Queensbury, NY 12804
Date Place Removed
ZZ ❑Removal and/or Held
and/or Address
H Hold
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Q Date Point of
Nn Transportation Shipment
p by Common Destination
Carrier
n 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 Road,Queensbury, NY 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
1 Address
US
CU
Permission is hereby granted to dispose of the human Emains des ibed ab as indicat d.
Date Issued 0 (17 /(� Registrar of Vital Statistics Q7- �-e- s/`-e
( ignature)
District Number ,n24,6 / Place %—,d Ca;-E4
I certify that the remains of the decedent identified above were disposed of in accordance ith this permit on:
tu Date of Disposition MM. Place of Disposition Zo., Lttivr ,r•i
W (address)
Cl)
a' (section) (lot number) (grave number)
QName of Sexton or Person in Charge of P mises L�,f. sG
Z
tu
al
se p(ple rint)
Signature fr Title [( U40-
(over)
DOH-1555(02/2004)