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Steidle Sr., Raymond Joseph NEW YORKSTATE DEPARTMENT OF HEALTH ..--110kb. Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Raymond Joseph Steidle Sr. Male Date of Death Age If Veteran of U.S.Armed Forces, 12/02/2021 80 Years War or Dates 1.., Place of Death itution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Manner of Death Pending l0 © Natural Cause �Accident �Homicide �Suicide �Undetermined � W Circumstances Investigation W Medical Certifier Name Title Ch Shahid Ahmed MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 572 ❑Burial Date Cemetery,Crematory or Facility Name 12/06/2021 Pine View Crematory ElEntombment Address u Cremation Queensbury Town,New York ❑Donation Z Removal Date Place Removed and/or and/or Held H Hold Address N 0 a. Date Point of U) ❑Transportation Shipment p by Common -- Carrier Destination ❑Disinterment Date Cemetery Address 0 Reinterment Date Cemetery Address 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 1— Remains are Shipped,If Other than Above 5 Address OC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/06/2021 Registrar of Vital Statistics 2Rgbert Andrew Curtis(ElectronicallySigned) (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: H Z Date of Disposition ltlti Ili Place of Disposition eij,- rLtv._. ILI 2 (address) LU CC (section) (lot number) C•- (grave number) CC 0 4:; 0L Name of Sexton or Person in Charge of Preis - � t Ze print) lL 114 Signature `,% Title �+` �`� DOH-1555(07/18)p 1 of 2 r _ � rl -, Public Health Law Sec. 4145(2b) �. � � Receipt � tf Human remains of i .. ` - 1 ' delivered on • , 20' ` 'fJ Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# '~'