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Smith, Aaron Jason NEW YORKSTATE DEPARTMENT OF HEALTH Lic\F. , Z�� Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Aaron Jason Smith Male Date of Death Age If Veteran of U.S.Armed Forces, 02/25/2024 49 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address 150 South Street Unit B, Glens Falls, New York 12802 W Manner of Death ❑X Natural Cause Accident1=1 Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title O Timothy Murphy Coroner Address 52 Haviland Avenue,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 118 Burial Date Cemetery,Crematory or Facility Name 02/29/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ZZ❑Removal Date Place Removed and/or and/or Held H Hold Address f)❑Transportation Date Point of p by Common Shipment Carrier Destination Disinterment 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 1— Remains are Shipped,If Other than Above 2 Address Q W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/27/2024 Registrar of Vital Statistics Megan Wo(in(E(ectronica1Ty Signed) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition 3—/-2 7, / Place of Disposition P,n Q_U%Cita{ Gf_✓Tfir t 2 (address) W CC (section) (lottnumber) (grave number) g -it,/I i G,v1 V �� Name of Sexton or Pers in Ch a of Premises (please print) W Signature Title w // DOH-1555(o7/18)p of 2 Public Health Law Sec. 4145(2b) -': i .1, Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#