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Vopleus, Cecil G 5-5( NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records •Name First Middle Last Sex Cecil G.Vopleus Male Date of Death Age If Veteran of U.S.Armed Forces, 07/14/2023 93 Years War or Dates F• Place of Death Hospital,Institution or W City,Town or Village Thurman Town Street Addltss 671 High Street,Thurman Town, New York 12810 • Manner of Death ❑^ Natural Cause Accident Homicide CSuicide Undetermined Pending W Circumstances Investigation GMedical Certifier Name Title Suzanne Bergin DO Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Thurman District Number Register Number City,Town or Village 5659 5 Burial Date Cemetery,Crematory or Facility Name 07/17/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ❑Removal Date Place Removed and/or and/or Held - Hold Address 0 a Date Point of Cl) Transportation Q by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg, New York 12885 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above Address Q W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/17/2023 Registrar of Vital Statistics Cynthia X 71:yde(ECectronicalTy Signed) (signature) District Number 5659 Place Town Of Thurman I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 1 1 l$1 j� Place of Disposition �.,��,(_ 2 (address) W N (section) (tot number/ (grave number) //Name of Sexton or Person in Charge of P mises nr �-- t (3se print) W Signature Title � W�� DOH-1555(07/18)p i of 2 . . t 71 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#