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Dunkley, Eugene Anthony LI- \ 6 % NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Eugene Anthony Dunkley Male Date of Death Age If Veteran of U.S.Armed Forces, 08/10/2023 76 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Johnsburg Town Street Address 86 Bartman Road,Johnsburg Town,New York 12811 `p Manner of Death ZI Natural Cause Accident El Homicide Suicide Undetermined El Pending Circumstances Investigation WMedical Certifier Name Title CI Suzanne Bergin DO Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Johnsburg District Number Register Number City,Town or Village 5655 28 Burial Date Cemetery,Crematory or Facility Name 08/14/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York ElDonation OZ❑Removal Date Place Removed and/or and/or Held H N Hold Address 0 O. Date Point of N Transportation p 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 I— Remains are Shipped,If Other than Above Address CC W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/14/2023 Registrar of Vital Statistics Jean M Comstock(ECectronica(CySigned) (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: F � Z Date of Disposition g1 M VZ3 Place of Disposition 1 J (address) W CC N (section) I(tot number)N, (grave number) 8 Name of Sexton or Person in Charge of P s (p se print// W Signature Title /p 7f DOH-1555(07/t8)p t of 2 1. 0 .t-7e cl Public Health Law Sec. 4145(2b) Receipt Human remains of :; f ..., delivered on , 20 f .' Pine View Cemetery Repres n ing urieral home named on burial permit Official Funeral Directors Reg.or License#