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Swinton, Arthur David 1.,, F AlI NEW YORKSTATE DEPARTMENT OF HEALTHBurial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Arthur David Swinton Male Date of Death Age If Veteran of U.S.Armed Forces, 01/22/2024 77 Years War or Dates F. Place of Death Hospital,Institution or Z City,Town or Village Fort Edward Town Street Address 2433 County Road 46 Road,Fort Edward Town,New York 12828 LLI p Manner of Death Z Natural Cause EAccident El Homicide 0Suicide Undetermined Pending W Circumstances Investigation U W Medical Certifier Name Title Ca Karen Going NP Address 325 Main Street, Hudson Falls Village,New York 12839 Death Certificate Filed Town Of Fort Edward District Number Register Number City,Town or Village 5755 10 EBurial Date Cemetery,Crematory or Facility Name 01/24/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held H Hold Address CO 0 d Date Point of Cl) Transportation Q by Common Shipment Carrier Destination D Disinterment Date Cemetery Address El Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward, New York 12828 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 5 Address C W a Permission is hereby granted to dispose;.of the human remains described above as indicated. Date Issued 01/24/2024 Registrar of Vital Statistics Aimee L Mahoney(ECectronicaCfySigned) (signature) District Number 5755 Place Town Of Fort Edward I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H W Date of Disposition '—dN;-4,0-21-u Place of Disposition P;nc, V.L./ C,i' +st,klY 2 (address) W N Q (section) (lot number) (grave number) O▪ Name of Sexton or Person in C arge of Premises TCM,,),' SQ.i;r.c. Z (please print) Z W Signature Title C•C4.iM )ic,r DOH-1555(07/18)p 1 of 2 :11 7 +y 1y 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#