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Howe Sr, Bernard DEPARTMENT OF HEALTH ��S NEW YORK STATE ,� Vital Records Section E Burial - Transit Permit Name First Middle Last Sex y£,, Bernard A. Howe,Sr. Male _ 1 Date of Death Age If Veteran of U.S. Armed Forces, a . July 14,2014 85 War or Dates Korean : Place of Death Hospital, Institution or Z. City, Town or Village Glens Falls Street Address Glens Falls Hospital ` Manner of Death n Natural Cause 1 Accident n Homicide Suicide Undetermined Pending AU Circumstances Investigation ILL Medical Certifier Name Title Marvin Davidowitz Address :* 100 Park St.,Glens Falls,NY 12801 Death Certificate Filed District Number Register Number City, Town or Village Glens Falls 5601 (. 702 ❑Burial Date Cemetery or Crematory July 16,2014 Pine View Crematory ❑Entombment Address ©Cremation 21 Quaker Rd., Queensbury, NY 12804 Date Place Removed Z I I Removal and/or Held and/or Address I_ Hold N 0 Date Point of O. I !Transportation Shipment 5 by Common Destination Carrier I I Disinterment Date Cemetery Address Reinterment Date Cemetery Address -x Permit 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 Address 6 La % Permission is hereby rant d to dispose of the human mains d scribed a ove as Ind! ated. Date Issued Ile ' d! Registrar of Vital Statistics c 7)`-c X (signature) E District Number 5601 Place Glens Falls //U/I / I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Z 1/.,,J Comae � Date of Disposition `J-IP,"I`� Place of Disposition i4� (address) W a � O (section) (to umber) (grave number) p Name of Sexton or Person in Charge of Premises t`'F`,c �n ' Z (please nt) W' Signature (,. /6"-- Title 61.1-V'I/jii (over) DOH-1555 (02/2004)