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Allen, Cordia E ‘° NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Cordia E Allen Female Date of Death Age If Veteran of U.S.Armed Forces, 07/31/2021 60 Years War or Dates F. Place of Death Hospital,Institution or W City,Town or Village Corinth Village Street Address 105 Mill Street 2-C,Corinth Village,New York 12822 p Manner of Death ©Natural Cause El Accident ❑Homicide Suicide ❑Undetermined Pending W 0 Circumstances Investigation W Medical Certifier Name Title O Arthur Nolan Coroner Address 487 Sandhi!!Rd.,Greenfield Center,New York 12833 Death Certificate Filed District Number Register Number City,Town or Village Corinth 4553 EiBurial Date Cemetery,Crematory or Facility Name 08/03/2021 Pineview Crematory ElEntombment Address IDCremation Queensbury Town,New York ElDonation Removal Date Place Removed and/or and/or Held N Hold Address O Date Point of Cl) Li Transportation Shipment p by Common Carrier Destination El Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom F- 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 08/03/2021 Registrar of Vital Statistics Brenda L Penis(Electronically Signed) (signature) District Number 4553 Place Corinth, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: l+ u W if of Disposition 14 Place of Disposition I (address) W N (section)0 (l um)er) (grave number) \ r 0 Name of Sexton or Person in Charge of Premis �' (please p) ) ils W Signature Title C /Vit. DOH-1555(07/18)p 1 of 2