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Sherman, Alice L
AUF 74q NEW YORK STATE DEPARTMENT OF HEALTH - Transit Permit' Bureau of Vital Records Burial Name First Middle Last Sex Alice L.Sherman Female Date of Death Age If Veteran of U.S.Armed Forces, 03/18/2024 75 Years War or Dates Place of Death Hospital,Institution or lZL City,Town or Village Johnsburg Town Street Address Elderwood at North Creek 0 Manner of Death ❑^ Natural Cause Accident Homicide Suicide Undetermined Pending LUCircumstances Investigation Medical Certifier Name Title 0 Wendy Steinhacker PA Address 112 Ski Bowl Rd,Johnsburg Town, New York 12853 Death Certificate Filed Town Of Johnsburg District Number Register Number City,Town or Village 5655 16 Burial Date Cemetery,Crematory or Facility Name 03/18/2024 Pine View Cematory Entombment Address ©Cremation Queensbury Town,New York Donation goRemoval Date Place Removed and/or and/or Held p Hold Address 0 Q. Date Point of Cl) Transportation p by Common Shipment Carrier Destination O Disinterment Date Cemetery Address OReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg, New York 12885 Name of Funeral Firm Making Disposition or to Whom F.. Remains are Shipped,If Other than Above g Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/18/2024 Registrar of Vital Statistics Jean 9l2 Comstock(ECectronica1Ty Signed) (signature) District Number 5655 Place Town Of Johnsburg I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: IH W Date of Disposition ?, l$174 Place of Disposition 2 (address) W CC CC (section) / (lot numbe (grave number) O Name of Sexton or Person in Charge of Pr i 0 1/p/ease print/ W Signature Title �r�iK,n)q DOH-1555(07/t8)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#