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Gessinger, Jeannette 14C. -F). NEW YORK STATE DEPARTMENT OF H EALTH � _., Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Jeannette Gessinger Female Date of Death Age If Veteran of U.S.Armed Forces, 01/03/2024 82 Years War or Dates Place of Death Hospital,Institution or ZCity,Town or Village Queensbury Town Street Address 55 Cascade Court,Queensbury Town, New York 12804 O Manner of Death ❑X Natural Cause Accident El Homicide ESuicide Undetermined ri Pending W Circumstances Investigation W• Medical Certifier Name Title a Robert Love MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 1 Burial Date Cemetery,Crematory or Facility Name 01/05/2024 Pine View Crematory Entombment _ Address ©Cremation Queensbury,New York Donation 0 El Removal Date Place Removed and/or and/or Held N Hold Address 0 O. Date Point of U)n Transportation Shipment o by Common Carrier Destination Date Cemetery Address Disinterment LI Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above a Address Q W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/04/2024 Registrar of Vital Statistics Caroline xftfeganfe Barber(Electronically Signed) (signature) District Number 5657 Place Town Of Queensbury I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition /o'20 Z 5 Place of Disposition Pi a e (/, e id C re-m w-le �( UJ 2 (address) --a W CC (section) (lot num (grave number) 8 Name of Sexton or Person in Charge of remises Kt-1//>» J' _ /61- Z (please print) W Signature Title � � DOH-1555(07/18)p 1 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# '