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Greenwood, Walter Kimball . 0 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Walter Kimball Greenwood Male Date of Death Age If Veteran of U.S.Armed Forces, 06/04/2023 76 Years War or Dates 1966-68 H Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital ILI `LI p Manner of Death 11.1 Natural Cause []Accident ri Homicide Suicide III Undetermined ❑Pending C.) Circumstances Investigation W Medical Certifier Name Title 0 William Cleaver MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 281 EBurial Date Cemetery,Crematory or Facility Name 06/07/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0 Removal LI Date Place Removed and/or and/or Held H Hold Address N 0 0. Date Point of U)[]Transportation p by Common Shipment Carrier Destination El Disinterment Date Cemetery Address ElReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom I— Remains are Shipped,If Other than Above N Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/06/2023 Registrar of Vital Statistics Megan.ragn(Ekctronicall:y Signer!) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: J IH � Z Date of Disposition �i/ 17 3 Place of Disposition -AL �fc 2 (address) W CCCC (section) / (lot number (grave number) 0 Name of Sexton or Person in Charge of Premises • ` ��'�`— w4if z (ptl4ase print) W Signature Title ` �H roe DOH-1555(07/18)p 1 of 2 ri f: *f i 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#