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Lindsey, Gerald F 36k NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Gerald F.Lindsey Male Date of Death Age If Veteran of U.S.Armed Forces, 04/19/2023 88 Years War or Dates 1953-1956 Place of Death Hospital,Institution or WCity,Town or Village Johnson City Village Street Address 33-57 Harrison Street,Johnson City Village,New York 13790 0 Manner of Death Z Natural Cause Accident []Homicide ESuicide Undetermined El Pending ILI Circumstances Investigation W Medical Certifier Name Title 0 Saqib lqbal DO Address 3101 Shippers Road 203,Vestal Town,New York 13850 Death Certificate Filed Village Of Johnson City District Number Register Number City,Town or Village 0303 254 Burial Date Cemetery,Crematory or Facility Name 04/21/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0 Removal Date Place Removed LI and/or and/or Held Hold Address 0 Date Point of U)[]Transportation p by Common Shipment Carrier Destination Date Cemetery Address Disinterment Date Cemetery Address Reinterment Permit Issued to Registration Number Name of Funeral Home Miller Funeral Home 01199 Address 6357 Nys Rte#30, Indian Lake,New York 12842 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above 5 Address C W EL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/21/2023 Registrar of Vital Statistics Maryann Kinne(Electronically Signed) (signature) District Number 0303 Place Village Of Johnson City I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: WDate of Disposition S/QZ21.2Z3 Place of Disposition rJ e V' 2 (address) W EC N (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of remises / /'7i7bn! Z (p ease print) 11J Signature Title Of�w r DOH-1555(07/18)p t of 2 V I ' 4 9 s r; 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#