Schmidt, Charles r v
Schmidt Lot No. 40 F
Lddress Route 8 Box 26 Wever Town N.Y. 12886 0026 Section No.
)caner Charles & Ella Schmidt Plot Mohican
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cati.o on Bounded North By Vacate, South By Beames , East By Scott &Morriso .
West BY Bolton & Mahoney
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)eed No. (and changes) 2677
'ayment Record 7/7/9 5 Paid Tn Full ( $7 0 0 , 0 0 )
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Form No. 01
Public Health Law Sec. 4145(2b) 012998
Receipt
Human remains of /2/^` tj S gCJJ fri i C 4 delivered on , 20
Pike View Cemetery Representing the funeral home named on burial permit
(Official Funeral Directors Reg.or License#
SCHMIDT
NAME Charles Schmidt Age: 93
Lot Owner: Charles & Ella Schmidt
Lot# Mohican 40 F Grave# 1
Case:Concrete
Died: 9.2 0.2 3 Interred: 9.2 6.2 3
Funeral Home: Baker FH
Cemetery: Pine View