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Morgan,Danielle Laurette I(Q3,gbi j., NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Danielle Laurette Morgan Female Date of Death Age If Veteran of U.S.Armed Forces, 02/18/2022 52 Years War or Dates H Place of Death Hospital,Institution or WCity,Town or Village Hartford Town Street Address 3433 State Route 196 Route,Hartford Town,New York 12827 00 Manner of Death ©Natural Cause 0 Accident EI Homicide El Suicide 0 Undetermined 1=1 Pending V Circumstances Investigation GMedical Certifier Name Title Darci Gaiotti-Grubbs MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number , City,Town or Village Hartford 5759 2 ❑Burial Date Cemetery,Crematory or Facility Name 02/22/2022 Pine View Crematory ❑Entombment Address ElCremation Queensbury Town,New York ❑Donation 0 Removal Date Place Removed and/or and/or Held f- Hold Address tit 0 CL Date Point of CA ❑Transportation p by Common Shipment Carrier Destination El Disinterment Date Cemetery Address EReinterment Date Cemetery Address _ Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward,New York 12828 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above IAddress Ill CL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/22/2022 Registrar of Vital Statistics Denise Petteys(ECectronica(TySigned) (signature) District Number 5759 Place Hartford, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z �J W Date of Disposition Z'Zj tZ Place of Disposition �„,,t(��.. L�i";� 2 (address) W N CC (section) /f (lot numb (grave number) if 0 Name of Sexton or Person in Charge of miles ntpleaseprint/ Z UJ Signature 1 Title ( hN{ DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 15 .E;O9 Receipt Human remains of delivered on , 20 t a Pine View Cemetery Representing the funeral home named on burial permit 1 Official 1 Funeral Directors Reg. or License#