Huffer, Homer Franklin Jr. Sgl
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Homer Franklin Huffer Jr. Male
Date of Death Age If Veteran of U.S.Armed Forces,
11/04/2023 69 Years War or Dates 1974-1977
1_ Place of Death Hospital,Institution or
W City,Town or Village Albany Street Address Albany Medical Center Hospital
`p Manner of Death 111 Natural Cause Accident Homicide 7Suicide EUndetermined nPending
C.) Circumstances 'I !!Investigation
W Medical Certifier Name Title
CI Gladys Hernandez
Address
43 New Scotland Ave,Albany,New York 12208
Death Certificate Filed City Of Albany District Number Register Number
City,Town or Village 0101 2616
HBurial Date Cemetery,Crematory or Facility Name
11/06/2023 Pine View Crematory
Entombment Address
-Cremation Queensbury Town,New York
[11Donation
0❑Removal Date Place Removed
and/or and/or Held
t Hold Address
an
0
n- Date Point of
Cl) Transportation
by Common Shipment
Carrier Destination
ODisinterment Date Cemetery Address
I Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078
Address
136 Main St,S Glens Falls,New York 12803
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 11/06/2023 Registrar of Vital Statistics Kerry Bartlrofomew(ElectronicallySt'ned
(signature)
District Number 0101 Place City Of Albany
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
F—
W Date of Disposition f i I9I Za, Place of Disposition T 41;r ts, a A t'WCYv"'�
2 (address)
W
CC CC (section) (lot number/a (grave number)
66r[1
g Name of Sexton or Person in Charge of Premises t' 1-- .,/+t
( ease print)
W Signature Title (f431,164;tk
DOH-1555(07/18)p i of 2
r 7 1 1 w, 6 5 3 9
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#