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Morris, Anne P " i; NEW YORKSTATE DEPARTMENT OF HEALTH ; t•., „�1 I Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Anne P.Morris Female Date of Death Age If Veteran of U.S.Armed Forces, 09/15/2023 80 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Halfmoon Town Street Address 53 New Netherland Way, Halfmoon Town,New York 12065 tJ.l Manner of Death Undetermined Pending t] Natural Cause AccidentIII Homicide Suicide tL Circumstances Investigation U WI Medical Certifier Name Title CI Kellie Forshey NP Address 445 New Karner Road,Colonie Town,New York 12205 Death Certificate Filed Town Of Halfmoon District Number Register Number City,Town or Village 4559 69 HBurial Date Cemetery,Crematory or Facility Name 09/18/2023 Pine View Crematory Entombment Address ©Cremation Queensbury, New York Donation Z Removal Date Place Removed and/or and/or Held H Hold Address N 0 tL Date Point of ton Transportation Shipment p by Common Carrier Destination nDisinterment Date Cemetery Address n Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home William J Burke&Sons Funeral Home 01827 Address 628 N Broadway,Saratoga Springs,New York 12866 Name of Funeral Firm Making Disposition or to Whom F_ Remains are Shipped,If Other than Above 2 Address CC W tL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/18/2023 Registrar of Vital Statistics Lynda cBryan(Electronically Signed) (signature) District Number 4559 Place Town Of Halfmoon I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— f, Z Date of Disposition q ii B 113 Place of Disposition ,a/ L}I_ LU 2 (address) W Cl) (section) Allot number) (grave number) Name of Sexton or Person in Charge of Premises ^v � 1tt z (plea print/ W Signature Title DOH-1555{07/18)p 1 of 2 t 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#