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Howe, Michelle I
39/- NEWYORKSTATEDEPARTMENTOFHEALTH - Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Michelle I.Howe Female Date of Death Age If Veteran of U.S.Armed Forces, 11/17/2023 77 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Chester Town Warren Street Address 1488 North Gore Road,Chester Town Warren,New York 12857 ILI p Manner of Death ❑X Natural Cause Accident Homicide DSuicide nUndetermined Pending Circumstances Investigation W Medical Certifier Name Title O Kate Sauer-Jones PA Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Chester District Number Register Number City,Town or Village 5652 20 Burial Date Cemetery,Crematory or Facility Name 11/20/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held N Hold Address 0 a Date Point of Cl) Transportation Shipment Q by Common 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 a Address Q W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/20/2023 Registrar of Vital Statistics Mindy Conway(Electronically Signed) (signature) District Number 5652 Place Town Of Chester I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: / Z Date of Disposition //-Z/—Zp Z 3 Place of Disposition �.r`1 e 1r`i e..� ej�-.00Na-f0 F`� W 2 (address) W CC CC (section). (tot number) (grave number) 8 Name of Sexton or Person in Charge o remi es ��Q ,ii b I,Jap r (please print) Z W Signature J�. ✓ Title 6 ti449 DOH-1555(07/18)p i of 2 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#