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Slater, June A. /2 get NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex June A.Slater Female Date of Death Age If Veteran of U.S.Armed Forces, 11/23/2020 94 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Warrensburg Town Street Address 25 Oak Street,Warrensburg Town, New York 12885 W Manner of Death Pending � © Natural Cause �Accident �Homicide Suicide �Undetermined W C.) Circumstances Investigation W Medical Certifier Name Title Bryan Smead MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Warrensburg 5660 29 Burial Date Cemetery,Crematory or Facility Name 11/30/2020 Pine View Crematory Entombment Address 0 Cremation Queensbury Town,New York Donation • Removal Date Place Removed - and/or and/or Held - Hold Address 0 a. Date Point of U) Li Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg, New York 12885 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/27/2020 Registrar of Vital Statistics (Pamela M Lloyd"(ECectronica1Ty Signed) (signature) District Number 5660 Place Warrensburg, 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 1)RP-ao7O Place of Disposition }Pi, ��2 Cre-71k/ (address) W CC N (section) (lot number) , (grave number) • Name of Sexton or Person in Cha e of Prerry7 s �/ laYf�v ' E.u.)42 0 (please print) Z W Signatureiy. f Title Dr�'J4�� DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 01:42410 Receipt Human remains of ' delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#