Austin, Deborah Hester NEW YORK STATE DEPARTMENT OF HEALTH
Bureau of Vital Records Burial - Transit Permit
Name First Middle Last Sex
Deborah Hester Austin Female
Date of Death Age If Veteran of U.S.Armed Forces,
08/23/2022 60 Years War or Dates
f.. Place of Death Hospital,Institution or
Z City,Town or Village Johnsburg Town Street Address 42 Goodman Road,Johnsburg Town, New York 12811
p Manner of Death El Natural Cause Accident Homicide Suicide Undetermined ❑Pending
W
C) Circumstances Investigation
QW Medical Certifier Name Title
Kate Sauer-Jones PA
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed Town Of Johnsburg District Number Register Number
City,Town or Village 5655 24
Burial Date Cemetery,Crematory or Facility Name
e 08/25/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
Date Place Removed
is Removal
H and/or and/or Held
N Hold Address
O
O. Date Point of
Cl)❑Transportation
O 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
3809 Main St,Warrensburg,New York 12885
Name of Funeral Firm Making Disposition or to Whom
—. Remains are Shipped,If Other than Above
Address
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O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 08/24/2022 Registrar of Vital Statistics jean M Comstock(ECectronicaltySigned)
(signature)
District Number 5655 Place Town Of Johnsburg
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I-
W Date of Disposition '-.t�j ). Place of Disposition }�/✓l(.. v Ctii cr,,,,uc
litcy
2 (address)
W
(section) (lot number) (grave number)
SName of Sexton or Person in Charge of Premises C}CJ!"'0 See A1 n,S
Z / (please print)
lW /✓
Signature f� / r.Title c 144(
DOH-1555(o7/18)p t of 2
01 6?, E:
1 _ . •Public Health Law Sec. 4145(2b) '
Receipt
1
1 Human remains of • \ delivered on • , 20
1
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1
1
Pine View Cemetery Representing the funeral home named on burial permit
Official - Funeral Directors Reg. or License# --'