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Guile, Sheri Ann 3Z7 NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Sherri Ann Guile Female Date of Death Age If Veteran of U.S.Armed Forces, 12/16/2020 57 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Fort Edward Village Street Address 9 Liberty Street, Fort Edward Village, New York 12828 LU C;) Manner of Death ©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending UCircumstances Investigation Q Medical Certifier Name Title Matthew Pender MD Address 35 Gilbert Street,Cambridge Village,New York 12816 Death Certificate Filed District Number Register Number City,Town or Village Fort Edward 5755 105 Burial Date Cemetery,Crematory or Facility Name 12/21/2020 Pine View Crematorium ❑Entombment Address 0 Cremation Queensbury Town,New York ❑Donation Z Date Place Removed O ❑Removal and/or Held H and/or N Hold Address O d Date Point of Cl) j Transportation p by Common Shipment Carrier Destination 0 Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom 1 Remains are Shipped,If Other than Above Address CC a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/18/2020 Registrar of Vital Statistics Aimee.Mahoney(ECectronicaCCy Signed) (signature) District Number 5755 Place Fort Edward, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H r� W Date of Disposition /Z-23-End Place of Disposition Core hi .G td ey 2 (address) W flA CC (section) 1 (lot nnimber) (grave number) gName of Sexton or Pers in arge of Premises Lim Y✓IG G " Z (please print) W Signature Title C ' fr'-404- 1T_ DOH-1555(07/18)p f 2 Public Health Law Sec. 4145(2b) ,€ :i 4 131 Receipt Human remains of delivered on ' , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#