Steinborn, Paul NEW YORK STATE—DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Paul Eric Steinborn Male
Date of Death Age If Veteran of U.S. Armed Forces,
December 26,2015 55 War or Dates
Place of Death Hospital, Institution or
X City, Town or Village Moreau Street Address 298 Lamplighter Acres
Manner of Death [Natural Cause Accident Homicide Suicide n Undetermined n Pending
Circumstances Investigation
Lia Medical Certifier Name Title
O John Delmonte Dr.
Address
3 Care Lane Suite 300, Saratoga Springs,NY 12866
Death Certificate Filed District NM Regis,tee,Number
City, Town or Village (� `r7
❑Burial Date Cemetery or Crematory
December 28, 2015 Pine View Crematorium
❑Entombment Address
❑x Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
ORemoval and/or Held
and/or Address
Hold
W
O Date Point of
ai❑Transportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan & Denny Funeral Home 01444
Address
94 Saratoga Avenue, South Glens Falls, NY 12803
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
W
¢' Permission is hereby granted to dispose of the human re escrib a ve as indicated.
Date Issued f ix I Registrar of Vital Statistics 17
J ( ' nature) p
District Number Place ,4770/c S "( iA-Ay j�L/ /�0 a Y
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition fl 3p,i3-- Place of Disposition die_ f t ems.) tie- y � ,`f
2 (addrelss)
W
N
(section) 1 (lot number) (grave number)
pName of Sexton or Person in Charge of Premises
(please print)
W
Signature Title G/'arnG,orter
(over)
DOH-1555(02/2004)