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Turner, Colleen Town of Queensbury Certification of Cremation a Pine View Cemetery and Crematory This certifies that the remains of: Colleen Turner were cremated on July , 9 20 21 at the Pine View (Month) (Day) Crematorium, Queensbury, New York, and these are the cremated remains of said body. Date of Death July , 2 20 21 Age 69 (Month) (Day) Funeral Home Baker Funeral Home Registered No. 554 Zji (Authorized Signature) NEW YORK STATE DEPARTMENT OF HEALTH BUrlal - Transit Pe It Bureau of Vital Records f ` Name First Middle Last Sex Colleen Jane Turner Female Date of Death Age If Veteran of U.S.Armed Forces, 07/02/2021 69 Years War or Dates F. Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital LU p Manner of Death ❑X Natural Cause El Accident Homicide Suicide Undetermined Pending W Circumstances Investigation U MIp Medical Certifier Name Title Sean Bain MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 272 ElBurial Date Cemetery,Crematory or Facility Name 07/06/2021 Pine View Crematory El Entombment Address ElCremation Queensbury Town,New York Donation Removal Date Place Removed F and/or and/or Held N Hold Address 0 a. Date Point of U) Li Transportation 5 by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home 01130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1 Remains are Shipped,If Other than Above .a Address LU C' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/06/2021 Registrar of Vital Statistics d'Pien,VVndrewCurtis(EkctronicaI'Signed) (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: Z Date of Disposition 7 lei Place of Disposition t 1 ff a� 2 (address) LU U) CC (section) n (lot number) C (grave number) • Name of Sexton or Person in Charge of Premise Z (pleae print) tU Signature r' Title C12 DOH-1555(o7/18)p t of 2 Public Health Law Sec. 4145(2b) 01_ 4 9 2 2 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License# COON Owner �, .John & Cynthia Coon -IWOK) CV' OINS Address 60 1`)`8 Plot Box 543, Hague, NY 128-3-6 1a'W5 Abenaki Phone # Lot # ��� La ► CI.-CiOs3 8C Deed # Date 2917 10/2/1 S Cost Foundatio N 1 , 050 Location Bounded on the North by West, South by LeRoux East by Vacant and West by VanVranken Remarks John Coon lot and Shirley West lot, switched in May 2002. See attached letter if there are any questions. Record of Interments 1 A) John Coon II 6/1 0/1 6 Crem 2 7 3r, /- �-7. 9- ao ai 8 o/i <A) liianci h.d 7-a- 26a/ 4 9 5 10 V i -vov� . 1� hi I c slo0 A cc. 1-1� is N —GQv�1 TURNER NAME Colleen Turner Age: 69 LF Lot Owner: John & Cynthina Coon Lot# Abenaki 8C Grave# 4 Case: Urn Died: 7/2/2 0 21 Interred: 7/1 3/2 0 21 Funeral Home: Baker FH Cemetery: Pine View