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Corda, Michael John
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Michael John Corda Male Date of Death Age If Veteran of US.Armed Forces, 01/06/2024 59 Years War or Dates i,„ Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address St Peters Hospital Ip Manner of Death ❑X Natural Cause Accident Ei Homicide Suicide Undetermined Pending Circumstances Investigation o 0 Medical Certifier Name Title G Christopher Guzda DO Address 315 S Manning Blvd,Albany,New York 12208 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 0059 ElBurial Date Cemetery,Crematory or Facility Name 01/10/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ZZ ElRemoval Date Place Removed - and/or and/or Held — Hold Address N 0 O. Date Point of N Transportation Shipment Q by Common Carrier Destination Disinterment Date Cemetery Address OReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home 01130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1.. Remains are Shipped,If Other than Above 2 Address CC W IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/10/2024 Registrar of Vital Statistics terry Bartholomew(E(ectronica((y Signed) (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: Z Date,gdDisposition III2IZy Place of Disposition f.'E4a.J CPF.414 r,_,.___ UJ 2 (address) W (I)IX (section/ /ot nmb / (grave number) 8 Name of Sexton or Person in Charge of P mises A1uer „, L it Z (p/ a print) W Signature Title L � � DOH-1555(07/18)p 1 of 2 n1 ',4J 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#