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Gilner, Gerard J NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Gerard J.Gilner Last Sex Date of Death Male Age If Veteran of U.S.Armed Forces, 05/25/2023 89 Years War or Dates 1951-1953 i Place of Death Hospital,Institution or Z City,Town or Village Johnsburg Town I Street Address Elderwood at North Creek tQ Manner of Death El Natural Cause Accident Homicide ESuicide ❑Undetermined ❑Pending 0 C.) Circumstances Investigation Medical Certifier Name Title Kate Sauer-Jones PA Address 112 Ski Bowl Rd,Johnsburg Town, New York 12853 Death Certificate Filed Town Of Johnsburg I District Number Register Number City,Town or Village 5655 20 Burial Date Cemetery,Crematory or Facility Name 05/26/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town, New York Donation 0❑Removal Date Place Removed and/or and/or Held CO Hold Address O Q. Date Point of CO❑Transportation CI by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address 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 f.. Remains are Shipped,If Other than Above a Address CC W Q. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/26/2023 Registrar of Vital Statistics Jean M Comstock(Electronically Signed) (signature) District Number 5655 Place Town Of Johnsburg I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H Z Date of Disposition 57Z7 Z0Z3 Place of Disposition Pi 1ti' 1 e.) C u111 1S� (address) W CC (section) (lot number)4 (grave number) Name of Sexton or Person in Charge of Pre ises Ka p'174,i`'' ) hL l 001 Z (Please print) W Signature Title 0��—°L r DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 1 Receipt 1 Human remains of delivered on , 20 ''•e View Cemetery Representing the funeral home named on burial permit Funeral Directors Reg.or License#