Hoffman, William it gf 7
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
William B.Hoffman Male
Date of Death Age If Veteran of U.S.Armed Forces,
10/22/2018 56 Years War or Dates
Place of Death Hospital, Institution or
: City, Town or Village Saratoga Springs Street Address Saratoga Hospital
Manner of Death 0 Natural Cause 0 Accident 0 Homicide Suicide Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
Enrico Bravo MD
Address
211 Church St,Saratoga Springs,New York 12866
h„A Death Certificate Filed District Number Register Number
= City, Town or Village Saratoga Springs 4501 553
jEIBurial Date Cemetery or Crematory
4- 10/23/2018 Pine View Crematory
Ej Entombment Address
®Cremation Queensbury Town, New York
Date Place Removed
Removal and/or Held
and/or Address
Hold
Date Point of
0 Transportation Shipment
by Common Destination
Carrier
I ` Date Cemetery Address
❑Disinterment
,:: ❑Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
I Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
mAddres4s
4 Permission is hereby granted to dispose of the human remains described above as indicated.
I Date Issued 10/23/2018 Registrar of Vital Statistics John rPTranck(EI ctronica1Ty Signed)
(signature)
District Number Place
4501 Saratoga Springs, New York
I certify that the remains of the decedent identified above were disposed of in accordance 7h:his t permit on:
Date of Disposition IC J2S II g Place of Disposition � � �
(address)
(section) (I t number)9 (grave number)
-21 C
Name of Sexton or Person in Charge of Premises a, L Jw^�I°
(plea print)
Signature !' / Title /izrnlin
(over)
DOH-1555 (02/2004)