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McWhorter, Faith Roberta Zs NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records - Name First Middle Last Sex a Faith Roberta McWhorter Female Date of Death Age If Veteran of U.S.Armed Forces, 03/06/2021 74 Years War or Dates Place of Death Hospital,institution or ZCity,Town or Village Argyle Town Street Address 1335 Coach Road,Argyle Town,New York 12809 Manner of Death © Ei Undetermined Pending Natural Cause Accident Homicide Suicide Circumstances Investigation Medical Certifier Name Title John Delmonte MD Address }, 3 Care Lane,Saratoga Springs,New York 12.. Death Certificate Filed District Number Register Number City,Town or Village Argyle r M1,= 5750 22 ❑Burial Date "matory or Facility Name JD03/09/2021 -w Cre l ory Entombment Address '76'ILEJCremation Queensbury Town,New York Donation Z Removal Date Place Removed and/or and/or Held N Hold Address 0 a.to ❑ Transportation Date Point of p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address , El Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077 Address 123 Main St,Argyle,New York 12809 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address W EL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/09/2021 Registrar of Vital Statistics Shelley 9,Ickgrnon(ECectronicallySigned) (signature) �f? District Number 5750 Place Argyle, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I . Date of Disposition 31t0'Zl Place of Disposition F !L ek--__ z2 (address) Ili la cc (section) (lotpumbed C (grave number) Name of Sexton or Person in Cha of Premises 7->''I c. "` it (pie e print) E. Signature 0 ,,_ Title filirdltralf DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 014E 2 0 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#