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DeHoney, Marilynn E
C.-0NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Marilynn E.DeHoney Female Date of Death Age If Veteran of U.S.Armed Forces, 03/18/2023 76 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Lake George Town Street Address 40 Carey Road,Lake George Town,New York 12845 pManner of Death Z Natural Cause Accident 0 Homicide ESuicide FlUndetermined riPending UI—ICircumstances Investigation W Medical Certifier Name Title 0 Sean Campanie NP Address 9 Carey Road,Queensbury Town, New York 12804 Death Certificate Filed Town Of Lake George District Number Register Number City,Town or Village 5651. 2 Burial Date Cemetery,Crematory or Facility Name MIMI 03/20/2023 Pine View Crematory _Entombment Address ©Cremation Queensbury Town,New York Donation Z❑Removal Date Place Removed and/or and/or Held F- Hold Address N 0 Date Point of (/) Transportation Shipment (3 by Common Carrier Destination Disinterment Date Cemetery Address ElReinterment 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 CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/20/2023 Registrar of Vital Statistics Patricia 1c`(inneySchuster(E(ectronicaftySigned) (signature) District Number 5651 Place Town Of Lake George I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 1- WDate of Disposition 31tI IZ3 Place of Disposition F.-AL , a.___ 2 (address) W NCC (section) if (lot number) ^ (grave number) 0 Name of Sexton or Person in Charge of Pre ises i) .V L- M"'.N ease print) Z W Title `�`�'"'��t Signature DOH-1555(07/18)p 1 of 2 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#