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Goard, Barbara Jane f 3? 1 NEW YORK STATE DEPARTMENT OF HEALTH `— Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Barbara Jane Goard Female Date of Death Age If Veteran of U.S.Armed Forces, 04/06/2023 92 Years War or Dates F- Place of Death Hospital,Institution or WCity,Town or Village Saratoga Springs Street Address 400 Church Street,Saratoga Springs, New York 12866 'p Manner of Death ❑X Natural Cause Accident Homicide ESuicide nUndetermined El Pending I—ICircumstances Investigation QW Medical Certifier Name Title Mirabelle Beck NP Address 394-402 Church Street,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 217 Burial Date Cemetery,Crematory or Facility Name 04/10/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 8❑Removal Date Place Removed and/or and/or Held ~ N Hold Address 0 d Date Point of t!) Transportation p by Common Shipment Carrier Destination oDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home 01130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above a Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/10/2023 Registrar of Vital Statistics Ofilion Moran(ECectronica1TySigned) (signature) District Number 4501 Place City Of Saratoga Springs I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition Hill/3 Place of Disposition ldress / W CO CC (section) A //oj number/ /grave number/ 8 Name of Sexton or Person in Charge of Pre 'ses ^"1 �-- lfi (Ise print) W Signature _ Title � 'MW1�rt DOH-1555(07/18)pi.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#