Green, Shawna •
State of Florida, Department of Health, Bureau of Vital Statistics
Mira"a BURIAL TRANSIT PERMIT
HEALTH DATE PRINTED:August 29,2018 TRACKING NUMBER: 2018140508
1. DECEDENT INFORMATION
Name of Deceased Date of Death
SHAWNA MARIE GREEN August 26,2018
Place of Death-County City,Town or Location Name of facility,or street address if not a facility
HILLSBOROUGH TAMPA 4008 SWANN AV W
Name and Address of Funeral Home/Direct Disposal Establishment Fla.Lic.No./Reg.No. Phone Number
VETERANS FUNERAL CARE INC F040002 F040002 (727)524-9202
15381 ROOSEVELT BLVD
CLEARWATER,FLORIDA,33760
Funeral Director/Direct Disposer Fla.Lic.No./Reg.No.
TERRY PLATTS F042754
2. BURIAL - TRANSIT PERMIT
The Florida Department of Health, Bureau of Vital Statistics
hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes.
Permit Number: 2018-F040002-5431
Date Issued: August 28,2018
State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL-AT-SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District 13 Approval Number: 181306658
4. CEMETERY OR CREMATORY
Place of Disposition: PINE VIEW CREMATORY 6 ,n
Method of Disposition: REMOVAL FROM STATE Date of Disposition: 7/4-I 6
EDRS maintains all statutorily required information regarding the death record and related
burial transit permit,therefore, returning the permit to the county health department is no
longer required.
If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so.
DH 326E,10/12
64V-1.011,Florida Administrative Code