Shortsleeve, Francis E DH-PHS-35-74 STATE OF VERMONT Permit No...........................
BURIAL-TRANSIT PERMIT
Permit for Disinterment, Transportation and Reinterment
Full name of deceased Date of death
1 Francis Edward Shortsleeve 2 6-6-88
Color or Race Age Sex Place of death (City or Town) (State)
a white 4 74 6 male 6 Rutland Regional Medical Ctr. Rutland, VT.
PERMISSION REQUESTED FOR:
❑ BURIAL VC4 CREMATION ❑ TEMPORARY STORAGE DISINTERMENT
(Complete Item 11 below) (Complete Item 12 below)
7.
Place of disposition (Cemetery or Crematory) (City or Town) (State)
• s.
Pine view Crematory, Glens Falls, New York
Name of funeral director Business Address
9 Aldous Funeral Home 10 44 NO. Main Street Rutland, VT. 05701
If temporary Place of (Name of vault) (City or Town) (State)
storage, fill storage
in this section:
11. . 11A 118 11C
If disinterment, Place of (Cemetery) (City or Town) (State)
complete this original
section: burial or
entomb- 12A 128 12C
ment (Sexton's Signature) (Date)
12. 12D 12E
PERMISSION IS HEREBY GRANTED TO REMOVE AND DISPOSE OF THE BODY IpK-NTOED ABOVE:
Signature of clerk or deputy �` City or Town Date
13.Joseph P. Barnhart, deputy,;; '� A 14, Rutland City ,5. 6-6-88
CEMETERY OR CREMATORY AUTHORITIES SqALL FILL OUT'`SECTIONS BELOW:
Body was: Date Name of
cemetery or crematory
/�p ; Section Lot No.
BURIED `" V /V!i L/Cl/ � t�'/J �Of�� ✓J� I�
17. 18. 19. 20.
CREMATED Location (City or Town) (State) Signature of Sexton or
El STORED
other person in charge
� �/{�
16. 21.