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Moses, Howard F. NEW YORK STATE DEPARTMENT OF HEALTH ~ Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Howard F Moses Male Date of Death Age If Veteran of U.S.Armed Forces, 02/03/2021 73 Years War or Dates p., Place of Death Hospital,Institution or Z City,Town or Village Moreau Town Street Address 33B Skylark Drive,Moreau Town,New York 12803 W Undetermined Pending W Manner of Death © Natural Cause �Accident �Homicide �Suicide Circumstances Investigation WMedical Certifier Name Title G Eugene Ladue Coroner Address 31 Woodlawn Ave.,Saratoga Springs,New York 12866 Death Certificate Filed District Number Register Number City,Town or Village Moreau 4562 9 ❑Burial Date Cemetery,Crematory or Facility Name 02/04/2021 Pine View Crematory ❑Entombment Address lCremation Queensbury Town,New York ❑Donation Z Removal Date Place Removed and/or and/or Held p N Hold Address yLi Transportation Date Point of S by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address El Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom I.. Remains are Shipped,If Other than Above 2 Address Q W n' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/04/2021 Registrar of Vital Statistics Leeann Eric ca6e(Efectronica1Ty Signed) (signature) District Number 4562 Place Moreau, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: z .FL4,...... iW Date of Disposition ��S. /2( Place of Disposition .F .,IL IW NCC (section) (lot n beF1 (grave number) gName of Sexton or Person in Charge of Premises, r`t 7 /""'^''p11 Z (please print W Signature 6� Title (L t�v DOH-1555(07/18)pi of 2 LF Town of Queensbury Certification of Cremation vo Pine View Cemetery and Crematory This certifies that the remains of: Howard Moses were cremated on February , 5 20 21 at the Pine View (Month) (Day) Crematorium, Queensbury,New York, and these are the cremated remains of said body. Date of Death February 3 20 21 Age 73 (Month) (Day) Funeral Home Regan Denny Stafford Registered No. 132 //9-5' (Authorized Signature) MOSES NAME Howard Moses LF Age: 73 Lot Owner: Howard F Moses Lot# Mohican 20D Grave# 1 B Case: Urn Died: 2/3/2 0 21 Interred: 9/1 7/2 0 21 Funeral Home:Regan Denny Stafford Cemetery: Pine View Public Health Law Sec. 4145(2b) ' 14 4 q I Receipt 4 Human remains of delivered on , 20,— Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#