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Staigar Sr., William W. NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex William W.Staigar Sr. Male Date of Death Age If Veteran of U.S.Armed Forces, 01/29/2021 89 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W `p Manner of Death ❑k Natural Cause IDAccident ©Homicide ❑Suicide ❑Undetermined 0 Pending Circumstances Investigation WMedical Certifier Name Title CI Marvin Davidowitz MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Nurrrber Register Number City,Town or Village Glens Falls 5604 65 ❑Burial Date Cemetery,Crematbty'or Facility Name 02/01/2021 Pine View Crematory ❑Entombment Address X❑Cremation Queensbury Town,New York ❑Donation ZO Removal Date Place Removed and/or and/or Held F Hold Address N 0 CL Date Point of fl) ❑Transportation p by Common Shipment Carrier Destination Date Cemetery Address El Disinterment Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Compassionate Funeral Care Inc 00364 Address 402 Maple Ave,Saratoga Springs,New York 12866 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/01/2021 Registrar of Vital Statistics Rp6ertjlairew Curtis g ctronicalryS rted) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: f' ~ IL Z Date of Disposition 212 1 71 Place of Disposition W 2 ( dress) W EC EC (section) (lot number/ (grave number) 0 Name of Sexton or Person in Charge of P mises I t � ^Ati Z (please print) W Signature Title rirfv1IYITV VO DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) a144R Receipt Human remains of ' delivered on .a- , 20 Pine View Cemetery Rep,poting the funeral home named on burial permit Official Funeral Directors Reg.or License# I