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Cutter, Rodney Gene
if ( NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Male Rodney Gene Cutter Date of Death Age If Veteran of U.S.Armed Forces, 02/14/2024 70 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Granville Town Street Address Slate Valley Center for Rehabilitation and Nursing W Manner of Death Undetermined Pending p Natural Cause Accident Homicide Suicide W Circumstances Investigation V Title W Medical Certifier Name CI Joshua Starteri NP Address 10421 State Route 40,Granville Town,New York 12832 Death Certificate Filed Town Of Granville District Number Register Number City,Town or Village 5756 7 Burial Date Cemetery,Crematory or Facility Name 02/15/2024 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York 'Donation Date Place Removed ZO❑Removal and/or Held — and/or N Hold Address Point of ((I)❑Transportation 0 Date Shipment p by Common Carrier Destination Date Cemetery Address Disinterment Ej 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 CC O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/15/2024 Registrar of Vital Statistics Jenny Linda M MarteCCe(ECectronica1Ty Signed) (signature) District Number 5756 Place Town Of Granville I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— Z Date of Disposition Z jj),I2t1 Place of Disposition S. {�) C(Tie/r1AY0�'*�J,►` W (address) W NCC (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises /1 �^ LI+'u ti- (please print) Z W Signature Title 1"06 fkiTOO DOH-1555(07/18)p 1 of 2 •Public Health Law Sec. 4145(2b) E h Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License#