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Saunders, Daunne Phyllis oAgce ts,LF) .' !,. 4 \ NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Daunne Phyllis Saunders Female Date of Death Age If Veteran of U.S.Armed Forces, 02/23/2023 89 Years War or Dates f,. Place of Death Hospital,Institution or W City,Town or Village Hudson Falls Village Street Address 46 John Street, Hudson Falls Village, New York 12839 a Manner of Death ZI Natural Cause Accident ❑Homicide ESuicide FlUndetermined ri Pending W U Circumstances Investigation ILIQ Medical Certifier Name Title Antonio Izzo NP Address 340A Main Street,Hudson Falls Village,New York 12839 Death Certificate Filed Village Of Hudson Falls District Number Register Number City,Town or Village 5726 4 Burial Date Cemetery,Crematory or Facility Name EI02/25/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held ~ o Hld Address CO 0 f1. Date Point of N 0Transportation Shipment p by Common Carrier Destination EI Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above 2 Address CC UI O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/24/2023 Registrar of Vital Statistics Cynthia Bardin(E(ectronica1tySigned) (signature) District Number 5726 Place Village Of Hudson Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: II— }� , ..J IDate of Disposition z Z.5-Z,3 Place of Disposition l . ,J e pi;e er g (� 2 (address) W NCt (section) :I mber) (grave number) GName of Sexton or Person in Charg f Pre ises t\ �1O,J, W Z (please print) W Signature 3. / ioel Title 0rent. DOH-1555(07/18)p 1 of 2 6 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine 7iew Cemetery Representing the funeral home namefi.;on by ial rnit Official Funeral Directors Reg.or License#1'` of