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Sharrow, Ronald W 1 g? NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Ronald W Sharrow Male Date of Death Age If Veteran of U.S.Armed Forces, 02/25/2022 81 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death ©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending flLI 0 Circumstances Investigation fill Medical Certifier Name Title 0 Kelly Maley PA Address Vti 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 128 ❑ Date Burial Cemetery,Crematory or Facility Name 03/01/2022 Pine View Crematory ❑Entombment E,,, Address 0 Cremation Queensbury Town,New York ❑Donation Date 0 El Removal Place Removed and/or and/or Held N Hold Address to ❑Transportation Date Point of p by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 14 ffi 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above N Address Er LA Permission is hereby granted to dispose of the human remains described above as indicated. Al It Date Issued 02/28/2022 Registrar of Vital Statistics .`Megan Wolin(ECectronicaffySigned) (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 31312/ Place of Disposition iii 2 (address) CO CC (section) lot nu ben) (grave number) Name of Sexton or Person in Charge of Pre ' sl-1vn,t /ple a print/ tu Signature Title /i?,Mt v0 l DOH-1555(07/18)p 1 of 2 - , 936 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#