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McGee , George Jerome Jr. NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex George Jerome McGee Jr. Male Date of Death Age If Veteran of U.S.Armed Forces, 02/03/2024 76 Years War or Dates 1967-1969 H Place of Death Hospital,Institution or Z City,Town or Village Queensbury Town Street Address 39 Longview Drive Apt.212,Queensbury Town,New York 12804 LU p Manner of Death ❑X Natural Cause Accident Homicide Suicide ❑Undetermined Pending Circumstances Investigation W Medical Certifier Name Title 0 Kimberly Saunders DO Address 377 Church Street,Saratoga Springs,New York 12866 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 26 Burial Date Cemetery,Crematory or Facility Name 02/08/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 6—ElRemoval Date Place Removed and/or and/or Held N~ Hold Address 0 0. Date Point of Cl)❑Transportation p by Common Shipment Carrier Destination EiDisinterment Date Cemetery Address Reinterment 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 H Remains are Shipped,If Other than Above 2 Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/08/2024 Registrar of Vital Statistics Caroline H'Cfegarcfe Bar6er(E(ectronica1ty 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: Date of Disposition ,R-V-,?c2 V/ Place of Disposition i i/JeILL . �, l e','`�'�'1 J`•.l 2 (address) IW EC EC (section) (lot number) (grave number) . 1 S Name of Sexton or Person in Charge of P emise egyin40✓11. WL'Y1� Z (please print) IW Signature �•=j /�'� Title 0 DOH-1555(07/18)p t 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#