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Franck, William Scott -1F 6 NEW YORK STATE DEPARTMENT OF HEALTH v Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex William Scott Franck Male Date of Death Age If Veteran of U.S.Armed Forces, 01/01/2022 74 Years War or Dates 1964-1969 Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address Albany Medical Center Hospital Wp Manner of Death ©Natural Cause ❑Accident El Homicide 1=1 Suicide 0Undetermined El Pending W Circumstances Investigation W Medical Certifier Name Title 0 Laura Lambiase PA Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed District Number Register Number City,Town or Village Albany 0101 0003 ❑Burial Date Cemetery,Crematory or Facility Name 01/03/2022 Pine View Crematory ❑Entombment Address 0 Cremation Queensbury Town,New York ❑Donation Remand/oval Date Place Removed or and/or Held F N Hold Address 0 G. Date Point of U) Li Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address 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 2 Address tE 4' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/03/2022 Registrar of Vital Statistics (Danielle S Gillespie(ECectronicaf[y Signed) (signature) District Number 0101 Place Albany, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: . G/ P� W Date of Disposition I I S I ZZ Place of Disposition ._tL„ 2 (address) W Nfr (section) (lot number) (grave number) gName of Sexton or Person in Charge of P mises //i'3 44 IC Z (p/eese print) p� �� W Signature i-'l Title frEe Fes" DOH-1555(07/18)p 1 of 2 } 550 Public Health Law Sec. 4145(2b) Receipt Eft, Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#