Chandler-Finlayson, Kristina Danielle IT 3 9
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Kristina Danielle Chandler-Finlayson Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/06/2023 35 Years War or Dates
t` Place of Death Hospital,Institution or
Z City,Town or Village Moreau Town Street Address 1462 Route 9 8,Moreau Town,New York 12803
W• Manner of Death Undetermined Pending
ILEl
Cause Accident Homicide nSuicide --
✓ Circumstances Investigation
W Medical Certifier Name Title
CI David DeCelle Coroner
Address
40 McMaster Street,Ballston Spa,New York 12020
Death Certificate Filed Town Of Moreau District Number Register Number
City,Town or Village 4562 2
nBurial Date Cemetery,Crematory or Facility Name
01/10/2023 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
EiDonation
Removal Date Place Removed
and/or and/or Held
Hold Address
N
0
d. Date Point of
fA OTransportation
by Common Shipment
Carrier Destination
Date Cemetery Address
ElDisinterment .
Date Cemetery Address
E Reinterment
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
1— Remains are Shipped,If Other than Above
Address
CC
W
Cl-
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/10/2023 Registrar of Vital Statistics Leeann McCabe(Electronically Signed)
(signature)
District Number 4562 Place Town Of Moreau
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition it 73 Place of Disposition
(a dress)
W
CC N (section) / (lot number) (grave number)
g Name of Sexton or Person in Charge of isest
�plea�e,�rint/
W Signature Title l (rmnlq��
DOH-1555(07/18)p 1 of 2
01 6586
Public Health Law Sec. 4145(2b)
1
1
Receipt
Human remains of 'delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#