McGuire, David 488
TRANSIT COPY This STATE OF ARIZONA
copy must Permit Number
accompany body to DEPARTMENT OF HEALTH SERVICES-OFFICE OF VITAL RECORDS
final 2014MC-031182
DISPOSITION-TRANSIT PERMIT
NAME OF DECEASED: SEX: DATE OF BIRTH:
DAVID THOMAS MCGUIRE Male 11/2/1949
DATE OF DEATH: PLACE OF DEATH(CITY OR TOWN): COUNTY: STATE:
7/19/2014 Mesa Maricopa Arizona
CAUSE OF DEATH A:
IDENTIFICATION CARDIOGENIC SHOCK
OF DECEASED
CAUSE OF DEATH B:
ACUTE LEFT MAIN CORONARY INFARCTION
CAUSE OF DEATH C:
ATHEROSCLEROSIS
CAUSE OF DEATH D:
NAME AND ADDRESS OF FUNERAL FACILITY: /�
Regency Mortuary 9850 W.Thunderbird RdSun City,AZ S -?4
NAME OF FUNERAL DIRECTOR: SIGNATURE OF FUNERAL DIRECT y1 t DATE SIGNED:
MANNER AND JOHN PERKES PO ����= 07/22/2014
PLACE OF DISPOSITION METHOD(S): 4110
DISPOSITION Removal/Cremation
NAME AND LOCATION OF DISPOSITION FACILITY:
PINE VIEW CREMATORY Queensbury,NY 1 0
NAME AND LOCATION OF DISPOSITION FACILITY:
IN ACCORDANCE WITH ARIZONA STATE LAW AND THE REGULATIONS OF THE ARIZONA DEPARTMENT OF HEALTH SERVICES PERTAINING TO DEATH CERTIFICATES AND THE
HANDLING OF DEAD HUMAN REMAINS.AUTHORIZATION IS HEREBY GIVEN TO DISPOSE OF THIS BODY IN THE MANNER INDICATED.
AUTHORIZING REGISTRAR: DATE OF AUTHORIZATION:
AUTHORIZATION 07/22/2014
FOR DISPOSITION Michele Castaneda-Martinez
MEDICAL EXAMINERS AUTHORIZATION: AUTHORIZED FOR CREMATION: DATE OF AUTHORIZATION:
LESLEY WALLIS-BUTLER Yes 07/22/2014
I CERTIFY THAT THE ABOVE DESCRIBED REMAINS WERE DISPOSED OF AT THE FOLLOWING LOCATION AND BY DATE OF DISPOSITION:
THE METHOD SPECIFIED ABOVE. 07/22/2014 7df/ _/
NAME AND ADDRESS OF DISPOSITION FACILITY:
PINE VIEW CREMATORY Queensbury,NY f 53 0
DISPOSITION OF NAME OPERSON F�RGEO SPOSITION FACILITY�EPRINT): SIGNATURE:
REMAINS �� ,� 11
NAME AND ADDRESS OF DISPOSITION FACILITY:
NAME OF PERSON IN CHARGE OF DISPOSITION FACILITY(PLEASE PRINT): SIGNATURE:
MC R9-19-314 REQUIRES THAT A PERSON IN CHARGE OF A PLACE OF FINAL DISPOSITION IN ARIZONA SHALL MAINTAIN A COPY OF THIS
DISPOSITION TRANSIT PERMIT FOR FIVE YEARS FOLLOWING THE ISSUE DATE OF DISPOSITION.