Herrington, Sharon hf0
. . _
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Sharon Herrington Female
Date of Death Age If Veteran of U.S.Armed Forces,
10/20/2020 68 Years War or Dates
l— Place of Death Hospital,Institution or
WCity,Town or Village Glens Falls Street Address Glens Falls Hospital
p Manner of Death ❑X Natural Cause 1=1 Accident El Homicide ❑Suicide Undetermined 0 Pending
W U Circumstances Investigation
W Medical Certifier Name Title
CI Kelly Maley PA
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City,Town or Village Glens Falls 5601 481
❑Burial Date Cemetery,Crematory or Facility Name
10/21/2020 Pine View Crematory
❑Entombment Address
0 Cremation Queensbury Town,New York
❑Donation
Date Place Removed
Removal and/or Held
—
H and/or
N
Hold Address
0
Date Point of
Cl) ❑Transportation Shipment
Q by Common
Carrier Destination
Date Cemetery Address
ElDisinterment
Date Cemetery Address
ElReinterment
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
f.- Remains are Shipped,If Other than Above
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/21/2020 Registrar of Vital Statistics Rp6ert.,3nirewCurtts(Electronicall:y Signet°
(signature)
District Number 5601 Place Glens Falls, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition /0(23)Zt) Place of Disposition Ilia 216-.---.....
address)
W
CCCC (section) ((lot number) (grave number)
0 Name of Sexton or Person in Charge of Pr mises C � 9MA �
Z 1 (pie e print)
alTitle lr ttW(
Signature
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) a
Receipt
Human remains of delivered on , 20
•
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#