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Prince, Aaron, Andrew 41- gzc NEW YORK STATE DEPARTMENT OF HEALTH .LF Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Aaron Andrew Prince Male Date of Death Age If Veteran of U.S.Armed.Forces, 10/11/2023 59 Years War or Dates l- Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p• Manner of Death �Natural Cause EAccident Homicide Suicide ❑Undetermined ❑Pending Circumstances Investigation W Medical Certifier Name Title Jeremy Di Bari MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 474 Burial Date Cemetery,Crematory or Facility Name 10/13/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation a❑Removal Date Place Removed and/or and/or Held �- Hold Address CO O O. Date Point of t/)❑Transportation Q by Common Shipment Carrier Destination o Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above 2 Address W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/13/2023 Registrar of Vital Statistics Megan.NoCin(ECectronicatty Signed) (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: F Z Date of Disposition Place of Disposition RAJ /� r Q 1It4J (-rGr9 a4,'t'r•s tU 2 (address) W CC N (section) (lot number) Cl (grave number) Name of Sexton or Person in Cha e of Pr ises k14 in it)a L)� (please print) W Signature Title p p 1 DOH-1555(o7/18)p 1 of 2 • s 017374 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# •