Vedder, Howard F ib
NEW YORK STATE DEPARTMENT OF HEALTH V`
Bureau of Vital Records Burial - Transit Permit
Name First Middle
Last Sex
Howard F Vedder
Date of Death Male
Age If Veteran of U.S.Armed Forces,
08/20/2022 69 Years War or Dates
F.. Place of Death Hospital,Institution or
WCity,Town or Village Glens Falls Street Address Glens Falls Hospital
Up Manner of Death EiNaturalCause Accident Undetermined ❑Pending
Homicide Suicide
LU Medical Certifier Name Title Circumstances Investigation
0
Lynn Keil PA
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed City Of Glens Falls District Number
City,Town or Village 5601 Register Number
435
Burial Date Cemetery,Crematory or Facility Name
08/24/2022 Pineview Crematory
Entombment Address
(Cremation Queensbury Town,New York
Donation
Qa Removal Date Place Removed
and/or and/or Held
N Hold Address
0
Lt. Date Point of
Cl)DTransporlation
by Common Shipment
Carrier Destination
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
E— Remains are Shipped,If Other than Above
5 Address
Q
W
Lt. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 08/23/2022 Registrar of Vital Statistics Megan Nolin(Electronically Signed)
(signature)
District Number 5601 Place City Of Glens Falls
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:II
Date of Disposition '�j-241-zp7z Place of Disposition I t,r� Vic,e,� Ct€i ►a ,r'
(address)
et
N
(section) (lot number) (grave number)
g Name of Sexton or Person in Cha of Pre ises// R 14.1 g
nelo )� �00
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W Signature Title O�J
DOH-1555(WWn8)p 1 of 2
*1 /�j
I Public Health Law Sec. 4145(2b)
Receipt
1 Human remains of delivered on , 20 -
1
1
1
1
1
Pine View Cemetery Representing the funeral home named on burial permit
1 Official Funeral Directors Reg.or License#