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Duquesnel, Ronald George Town of Queensbury _ Certification of Cremation Pine View Cemetery and Crematory This certifies that the remains of: Ronald George Duquesnel were cremated on April 1 20 23 at the Pine View (Month) (Day) Crematorium, Queensbury, New York, and these are the cremated remains of said body. Date of Death March , 24 20 23 Age 57 (Month) (Day) Funeral Home Regan.Denny,Stafford Funeral Home Registered No. 301 (Authorized Signature) # 3 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Ronald George Duquesnel Male Date of Death Age If Veteran of U.S.Armed Forces, 03/24/2023 57 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Albany Street Address Albany Medical Center Hospital p Manner of Death El Natural Cause Accident ❑Homicide Suicide Undetermined Pending VCircumstances Investigation ILI Medical Certifier Name Title Antonio Sturges Coroner Address 175 Green Street,Albany,New York 12202 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 0780 Burial Date Cemetery,Crematory or Facility Name 03/30/2023 Pine View Crematory _Entombment Address ©Cremation Queensbury,New York Donation 0 El Removal Date Place Removed and/or and/or Held _ N Hold Address Transportation Date Point of Cl)/) a by Common Shipment _ _ Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom t.. Remains are Shipped,If Other than Above 2 Address W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/30/2023 Registrar of Vital Statistics Danie(Ce S GifCespie(ECectronica1Ty Signed) (signature) District Number 0101 Place City Of Albany I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H W Date of Disposition / �''0Z� Place of Disposition ?de_ 1,4 �) Cf-,744-t--� (addres*J LLJ (section) (lot number (grave number) SName of Sexton or Person in Charge of Pre 'ses Yi ,. (please print) IJ! Signature d ,/ f Title ©et-A-k DOH-1555(07/18)p 1 of 2 • _-To 1 y pp 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# Duquesnel NAME Ronald George Duq - •ge: 57 Lot Owner: Yvonne Duquesnel Lot# Erie 41 E Grave# 1A Case: Urn Died: 3 .2 4 .2 3 Interred: 6.3.2 3 Funeral Home: Regan Denny Stafford Cemetery: Pine View Dkekelkot e_ Sqc- L • Owner Yvonne DUquesnel Address Plot 1 Sparrow HawK Circle, Halfmoon, NY 12065 _ Erie Phone # • Lot # 518-744-8006 41E Deed # Date 4307 1 .28.22 Cost Foundation Y - N $650.00 Location West-Vacant East-Steele South-Vacant North-Path Remarks I ACKNOWLEDGE THE RECIEPT OF THE RULES AND REGULATIONS OF THE PINE VIEW CEMETERY: SIGNATTURE: DATE: / 38 SIGNATURE: DATE: F fS Record of Interments s•a% as 6 can �� u�sr�e l- l(n•as x iao\ � c,�.�- to 3 7 3 8 4 9 5 10 TA • y w Q A a s < 1T1 s��t�-