http://barrycountyhistoryportal.org/files/original/28/867/Burial_Transit_Permits_1980s.pdf 70798d1a3a3eef18e1d765fdf36f3113 PDF Text Text THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased. No------------------------------— MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368,of 1978 And Act 299 of 1980 . , TRELLIS rf. cor Dateofdeath_Se2LU^88_ Cardiac Arrest Cause of death Place of death________ Rare Hastings Twp Barry g^(Towi£hip or village or city) (County) Method of disposal Age------ (Cemetery or orem^r^i ---------- State ~~1 County Signature of Medical Examiner 86 a Woodland Memorial Park (Whether burial, cremation, storage, APPROVED FOR CREMATION Ser F White ________ 2— Date. 19. A certificate of death having been filed as required by the laws or regulations of this state, permission is KooPs Funeral Chapels, Inc. Address935 4th Ave* Lake Odessa, Mich. h.rehy giv.n tn (Funeral director or person acting as such) to disposezorto? of said deceased. Signatu' * . v/ er"____________________ _■ r>ato -------- * Y) Registra1 September 19 19 88 |or,Q Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. HUtt .o (Cemetery"orcrematory) Signature (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 date April 11, 1988 Number C- 6555 CREMATED REMAINS OF KARL F. DILLENBECK Evergreen Mortuary & Cemetery MORTUARY CREMATORY orth Oracle Road cson, Arizona 85705 5 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of dpreased Cause of death No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 DAVID JOHN BRQDBECK Date of death Feb** 6, 19 88 .______________________ _ Traumatic cardiac arrest Place of death Lansing___________ Ingham Method Of dianneai ^Bffrlal (Township or vniage or W (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION M Agp 61 dty> Woodland Memorial Park (Cemetery or crematory) - State Barry | County---- Signature of Medical Examiner Michigan----i 19 Date A certificate of death having been filed as required by the laws or regulations of-this state, permission is Koops Funeral Chapel hereby given addw* Lake Odessa, Michigan (Funeral director or 'person actin* as such) to dispose of Signature. February 9, Date. (Check 19 88 irtuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. (Cemetery or crematory) Signature. (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) -Azv/ THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION 1-26 5/84 BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH i ™ Act A58 of 1978 and Act 299 of 1980 • oo -.. . a a Viola E. Cappon ..Jan. 10 ..88 Full name of deceased_______________________ r Date of death _____ 19______ Cause of death Conaavyiwe- Barry <Co8trt?ial Place of death Method of disposal _______________________ HsNKV smF Cemetery ____________________________________________________ Hastings rbcbWhite (Whether burial, cremation, storage,p y I County APPROVED FOR CREMATION Signature of Medical Examiner hereby given Age 99 (Town.hip «viii.ee or cit)^00(jjari(j ft £ <Cemetery or crem .. --------- Statg , _______ —__________________ Date H -------19 A certificate of death having been filed as required by the laws or regulations of this state, permission is Girbach Funeral Home AddrBM 'Hastings, Michigan (Funeral director or person actin * as such) to dispose of body of said deceased. signature (Check one: Body waa x Registrar. * X Q FuQeral Director, tho January 13 19 88 gg Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW /3 19a in ____________- (State whether cremated, buried, stored, e£c-) a Csi gnatu . (^nyten^r crematory) _________________ • (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 (OVER) 5/84 �TH1S p ERM IT MUST ACCOMPANY REMAINS TO DESTINATION THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased ■ • Cause of death Place of death Sex — Age. IQ— (Township or village or city) .. Woodland \eme^egY Rnrjal Method of disposal 19 89 ______________ Ann Arhnr------------------------ Race—White Washtenaw (County) (Whether burial, cremation, storage, etc.) [ County APPROVED FOR CREMATION (Cemetery or crematory) State Barry Mrihigan — ——----- —--------------- Date Signature of Medical Examiner —19 . ■ A certificate of death having been filed as required by the laws or regulations of this state, permission b hereby given to 105 Capital Ave-f NR- Address Farley-Estes Funeral Home (Funeral director or person acting as such) to dispose of body of said deceased. Battle Creek, MI 49017 J . Signature Date. Registrar, DFE_____ _ Funeral Director, Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACg BELOW Body was____cZ_______________________ /£._ _________________ _____ :------------ in (State whether cremated, buried .^stored Aetc.) Plaq^-AV^^/ (CemeteryTo'r crematory) r Signature ' ---------- (Sexton or person in charge) • This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). BURIAL—TRANSIT PERMIT Cause . of death Place of HPath Pneumonia BarrV Method of di.nn.ai (C0Unty) ' Hastings Twp. Buriaf—h,p°rv,ll—'ty) R,pa ______ White' -------- _---------Spv Mal^gJg Woodland Memorial Park_______ (Whether burial, cremation, storage, etc.)o , (Cemetery or crematory) , - APPROVED FOR CREMATION--------------------------- 1 . _ort ^2- Signature of Medical Examiner. hereby given No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 HARRY MELVIN SANDBROOK Date of death SePt Full name of deceased. Dateu- 19--------- A certificate of death having been filed as required by the laws or regulations of this state, permission is KooPs Funeral Chapels,' Inc. ■■ ArtHrBM 935 4th Ave.- Lake Qdessa^MI m □neral director or person acting as such) to dispose of bpdy of saic) deceased. _______________ nBt<, September 13, Signature. (Check one: gegii is-®?- Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was—--------------------------- on. (State whether cremated, buried, stored, etc.) pure tunc J/iwq PA/? R — Signature__ ! (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 I No— MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Dani.G116 Patnce Roach Date of death 6—10 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased Cause of death Place Of death V 6 F a h G > Bacon Date of death July Us—19 § _______ /Superior twp. Washtenaw Age 88 (Cemetery or crematory) (Whether burial, cremation, storage, etc.) [County approved for cremation state Michigan. Barry... Signature of Medical Examiner- m SfY Fe White Woodland Cemetery _ purial Method of disposal Rarft (Township or village or city) (Couruv) — 19 Date _ A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei Nie Funeral Home,Inc, Address Ann Arbor, Michigan (Funeral director or person acting as such) to dispose of body of saicWeceased. < Signature.--------------(Check one: July 12, Date O Registrar, Funeral Director. 19-81 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was , . in 19 ------------- on' stored. etc^J (Cemetary xfftrematory) (" (Sexton or person in charge) ** . This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where therq is no sexton). B«26 3/87 THIS PERMIT M UST ACCOMPANY REMAINS TO DESTINATION, No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics (OVER) Authority: Act 368 of 1978 and Act 299 of 1980 BURIAL—TRANSIT PERMIT Full name of deceased Cause of death no MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 NORMA R. BARLOW _____________________ Date of death 4-8"* -PSEUDOMONAS SEPTICEMIA Place of death ____________________ - Race WHITE HASTINGS BARRY 19-88.... ' SexFE Aga-67 (Township or village or city) (County) Method of disposal WOODLAND MEMORIAL PARK BURIAL (Cemetery or crematory) (Whether burial, cremation, storage, etc.) i rnnnf.v ' bounty, APPROVED FOR CREMATION State Ml — state------ BARRY Signature of Medical Examiner —___ _____ ____ Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby yivPn'tn WREN FUNERAL HOME HASTINGS, MI (Funeral director or person acting as such) to dispose of hodyriof said deceased. / Date Signature// (Check one: Body Registrar, O Funeral Director, APR, 9___________ 19-88— Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW nn J/ 19^d^ in (State whether cremated, buried, stored, etc.L , / Z7 z (Cemetefyor crematory) Signatur (Sexton or person In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 (OVER) fa �TRANSIT COPY REGISTRAR'S DEPARTMENT OF HEALTH SERVICES - VITAL RECORDS SECTION (This copy must accompany body to final destination) FILE NO. ____________ BURIAL-TRANSIT PERMIT name of Darwin IDENTIFICATION OF DECEASED V f McClelland A January 6 1989 8. OEATH°F t. Cremated Remains Q OTHER BURIAL (SPECIF' CREMATION t. ANO >. 68 Male Apache Junction e *MU,T *C COMPLCTCO IF BODY is shipped out of STATE, MOVED SY COMI MANNER 2. color |s. White «■- iTATc----- Maricopa Arizona Bunkers Desert View Chapel 9702 East Apache Trail Mesa Az funeral DIAECToR’s 6a Yd signed" 1 PLACE OF DISPOSITION PLACE OF BuRIAl OR OTHER DISPOSITION REGISTRAR’S AUTHORIZATION Woodland Michigan Wood Land Memorial Park l2 R*<5 DaTE liGNEO FOR DISPOSITION BODY WAS} DISPOSITION ra BURIED Date of'D'ispoJiTIDn OF BODY STYE Rev'crnriTA STATE REGISTRAR USE 20. E“DTFid egistraR's Signatu CEMETERY MGR.: MAIL TRANSIT COPY IN 10 DAYS TO VITAL RECORDS. P.O. BOX 3887 DEPARTMENT OF HEALTH SERVICES, PHOENIX, ARIZONA 85030. ■k 7 VS-7 REV. 7-74 CEMETERY MANAGER'S SIGNATURE ,_____ 17. Doth er BURIAL—TRANSIT PERMIT Full name of deceased Cause of death Place of death Method of diannaal No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 RAY F. NEEB Date of death Dec. 29 G.l. Bleeding - Anemia Hastings Barry (C<>Unty> White M Agft 91 Woodiand Memorial Park p^Tegyhip or vmsge or dty> (Whether burial, cremation, storage, etc.) • APPROVED FOR CREMATION Signature of Medical Examiner 89 . (Cemetery or crematory) ------------ ~~1 <*-,------------ 8,^ _ _ 19-------- Date __ A certificate of death having been filed as required by the laws or regulations of this state, permission is 935 4th Ave. Lake Odessa, MI 48849 to dispose of^Wdjkof said deceasedXy/ < < Smd Zfar' L<?T Date January 2> 19 hereby given to KooP3 Funeral Chapels, Inc. AdHrP„ (Funeral director or person acting as such) * ICKecic one/JO Registrar, Body was Funjrfal Director, Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW nn 19 9^ - >n (State whether cremated, buried, stored, etc.) i Place---- PJLrf &—2---- _______________________ __ f a « 0 I drt w (Cemetery or crematory) Signature—-* ------------ ———------------(Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 �jb jKi/aLt—* w iNoii rtzKivlJu -------- no-------- :--------------------- l MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death Place of death Date of death CLAUDE C« KILPATRICK CALHOUN (Township or village or city) Method of disposal iq89 SexM— Ag>- 86 Rare WHITE BATTLE CREEK (County) 5*~20** _____ RESPIRATORY FAILURE _ . . - . — _ WOODLAND MEMORIAL PARK BURIAL (Cemetery or crematory) (Whether burial, cremation, storage, etc.) ----- Stete-MI— .... | County------ BARRY APPROVED FOR CREMATION 19— __ ___ ____ Date Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givet to-— WREN FUNERAL HOME Address HASTINGS, MI (Funeral director or person acting as such) to dispose of body of said d^eased, Signature-________--------------------------------------------------------- ---------------------- Date (Check one: k Q Funeral Director. 21_________ 19-§2 JRf Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW __________ on ______ \3&-3. in _____ *_______ Body was / Q Registrar. (State whether cremated^buried, stored, etc.) Placets J •%, ■r-> n (Cemetery or cr< matory) \ Signatur<QxQ>Mr<^^>^M,.4»,... CLsrhfhiQ g ‘ --------------- (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/M Authority: Act 368 of 1978 and Act 299 of 1980 MEMBER: MICHIGAN CEMETERY ASSOCIATION . phone AMERICAN CEMETERY ASSOCIATION <eiei) Mo-oeoo ... NATIONAL ASSOCIATION CEMETERIES •. NATIONAL CREMATION ASSOCIATION INTERNATIONAL CREMATION FEDERATION NATIONAL LOT EXCHANGE INTERNATIONAL LOT EXCHANGE 4341 CASCADE ROAD 8.E. • GRAND RAPIDS, MICHIGAN 49606 GRACELAND MEMORIAL PARK AND MAUSOLEUM Name, of Deceased James Henry..Lucas.. Place of Death Hastings.,... MI .Age 75 Date of Death ,Qc tobs.r. ..3.Q.,.. .19.8.9. Date Received .Qf?.t.Qb.SK...3.1.»... 19.89.... Date of Cremation .Qq.t.Qbe.K...31.....19.89 Destination of Cremains - Barry... ftpunty Cause of Death ..; Funeral Director ,.Eun.aral..Home......¥9.9.41^ .............. Metaata.tic...adenocaxcinonia..of...prostrate...;,.... �STATE OF FLORIDA .. DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES ,tx VITAL STATISTICS DEPARTMENT OF HEALTH ANO REHAtMUTATTVK SERVICES m. APPLICATION FOR BURIAL-TRANSIT PERMIT 11 ype or rnn Middle First 1. Name of Deceased Kauffman Daniel City, Town or Location k 2. Place of Death ’’ County Day Month Year 7 1989 April Name of (If neither, give street address) Hosp, or Inst. 1845 Avenue A» Kissimmee, Fl Kissimmee Osceola DATE OF DEATH Last 3. Name of Medical D Physician Certifier gth District Medical Examine^ Medical Examiner Phone Number Address 1401 Lucerne Terrace 0Rl» 244-7130 Address Phone Number (Area Code) Name ■‘4r’Fuheral Home/ f Direct Disposer Cox- Parker Carey Hand Guardian Chapel 1350 W. Fairbanks Ave. W.P 647-1942 , 5. Check Appro* ° * Box'6 a b O hours after death. He/$he verified that this death was from natural causes, that there was no accident nor other external cause of death, and that will complete and sign the medical certification of cause of death. / m--------- Mdeical Examiner 9Th District was contacted on 4—8—89 He/she verified that --------------- —*E* 9 Medical Examiner, will complete and sign the medical certification. wwi'.rxS by, ■ J c . 6. Funeral Director/ Direct Disposer The medical certification has been completed and signed. A completed certificate of death accompanies this application. .■ » was contactecl on within 72 Fla. Lie. No./Reg. No. Signature Date Signed > 3416 4-9-89 BURIAL-TRANSIT PERMIT B.- . Permit No. .300-9502—_ Permission is hereby granted to dispose of this body. A'five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship ‘would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director/Direct ifeooj Disposer Report" will be filed with the Local Registrar of the County in which death occurred. . . x «r< * (Z No extension of time for filing the death certificate requested. f Registrar-or a* . a Date z Date Certificate Subregistrar Signature -------------------------------------------------- Issued: —rr----------------Due:---------- - -------------------- C. O/fib AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA .... . '.Lv. h..- . .. • . . •• * ot/>b * ■ • . .. i . i' . Signature , Medical Examiner Date----------------------- ,...,—or Medical Examiner, :_________ gave authorization by telephone to •- • •_______ :________ ____________________________ Funeral Director/Direct Disposer. Date ________ _____ The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is required for all cremations. * . ... v CEMETERY OR CREMATORY Method of Disposition: S^BURIAL STORAGE CREMATION . . V Place of Disposition Date of Disposition ____ OTHER (Specify) REIWAL/BURIAL Signature of Sexton ) or Per$on*in-Charge ) This permit must be endorsed by the Sexton or person*in*charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the County where disposition occurred. - c£^ 3. 11 HRS Form 326, Oct 87 (Replaces May 86 edition which may be used) (Stock Number: 5740-000-0326-2) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAI^-TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics JAMES DUFFY-HOGAN---------------------------------- Date of death Sept. 17 49^85 Full name of deceased Cause of death Metastatic carcinoma of the colon____________________________________ Place of death Ionia_____________________________ Ionia (County) Race Burial Method of disposal """"mm■■m»■ p (Cemetery or crematory) j state Michisn Barry poumy— APPROVED FOR CREMATION Signature of Medical Examiner ------ _ 19 ________ _______Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver Koops Funeral Chapels, Inc Address Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of bodZbfsaid deceased. > Signatun Date. Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was JWjXfl_________________ on Sf/Tf/Afl iZJtoo gjL in QLPrfK (Slptc wjigjher cremated, buried, stored, etc.) 5 1 '*** (Cemetery or crematory) Place. -P/GZ.S... ------------------------- ______ Signature______________________________________________ .. • iSexton or person in charge) ' This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 BURIAL—TRANSIT PERMIT THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Age 78 woodland Memorial Park (Whether burial, cremation, storage, etc.) tn sex M white (Township or village or city) No MICHIGAN DEPARTMENT OF RJUBLIC HEALTH Office of the State Reglstraund Center for Health Statistics Full name of deceased Cause of death MYEREL E, KIDDEMfcy______________________ Date ofrdeath 7-21 19-8$ CEREBRAL VASCULAR AGGIDENT Place of death GRAND RAPIDS KENT (County) Rare WHITE §ex M Age 4 J (Township or village or city) BURIAL_______________________ WOODLAND MEMORIALPARK Method of disposal (Cemetery or crematory) (Whether burial, cremation, storage, etc.) “"""‘"""""""“““T?'"''''"! Cnnntv M [County APPROVED FOR CREMATION . BARRY Signature of Medical Examiner— — Mate, _______________ MI — Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver Addrr^ WREN FUNERAL HOME to HASTINGS, MI (Funeral director or person acting as such) to dispose of body oLsaidJUeceased.yO / Date Signature (Check one: Registrar. Funeral Director. JULY 22 19_S_$ Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW 19 ------------------------------------------ on Body was i(State whethertfemated. buried, stored, etc.) Placft^ , * I in (Cemetery or crematory) . Signature-------- r-------------- ------------ ___--------------------- I (/cu-'vuwu (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). B-24 4/18 Authority: Act 368 of 1978 and Act 299 of 1980 (OVER) �BURIAL—TRANSIT PERMIT CCOMPANY REMAINS TO DESTINATK 55 Full name of deeded nf d,,th May 30_19_89_ Cause Of death_____________ Multiple Injuries from Auto Accident____________________________ __ Place of death_____________ Eaton (County) Charlotte n jLAgeJL Race___ White .. . (Tbwnship or village or city) . Method Of disposal_______________________ Burial________________________ Woodland Memorial Park-------- IpPBOVBD (Whether burial, cremation, storage, etc.) (Cemetery or crematory! n FOR CREMATION---------------------------- 1 , . Hicfagg- Signature of Medical Examiner--------------------------------------- -------- — Data. --—- -------- 19-------A certificate of death having been filed;as required by the Jaws or regulations of this state, permission is hereby given tn KooPs Funeral Chapels, Inc, Address 935 4th Avenue Lake Odessa. (Funeral director or person acting as such) , to dispose oMSodyoTs sai d decease^. / PftAQ ' \ 4/ Signature/^—__________________ Hate_____ June 1,__________ 19 (Check one:7 0) Registrar. pt Fup/pil Directed Mortuary Science Licensee) THIS PERMIT ML co MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 STEVEN LEE FENSTEMAKER_____________ No___ CEMETERY OR CREMATORY AUTHORITY SHALL FILL. OUT: SPACE BELOW Body was____________ nn I . (State, whether cremated, buried, stored, etc.) (J PlaeelJJp7)rxJI j j ■ in__ ;----------------------------------------------------- 19 (Cemetery or {crematory) Signature^QzCt^Lg^a^x uc ' - ... (Sexton or person in charge) 1 This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 BURI AD—TRANSIT PERMIT No------- ---------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death DOROTHY V. FRIEND Date of death 6~9.= ~ RESPIRATORY FAILURE Place of death __ HASTINGS BARRY Race_WEITE ‘ Sex JUL Ag£2_ (Township or village or city) (County) Method of disposal WOODLAND MEMORIAL PARK--------------- BUR TAT. (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION Signature of Medical Examiner to 19.32. (Cemetery or crematory) — State I C°unty —BARRY ;___________________________ MI--------- Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver HASTINGS> MI WREN FUNERAL HOME Address. (Funeral director or person acting as such) to dispose of body j)f s deceas JUNE 12 Signature. (Check one: Registrar, O Funeral Director, 19_8S Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW On / 3 19^7 in (State whether cremated .buried. stored, ejc.) ' I (CemetaxAr crematory) PlaEgx/^ cJu&JL /? Signature *7^ *on <r;n«ch------------------- Body was-------- This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). B-26 4/M Authority; Act 368 of 1971'and Act 299 of 1910 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 MARIAN M. FARLEE Date of Full name of deceased th July. 29 89 iq Cause of death Stroke---------------------------------------------------------- ------------------------------------------------ . Place of death Kent Grand Rapids sex _F White , (Township or village or city) (County) , Burial Method of disposal Age 65__ . i Woodland Memorial Park (Whether burial, cremation, storage, etc.) ----------------------------------------------------------------------------- nsimh, APPROVED FOR CREMATION LU y ’ ■■ n (Cemetery or crematory) „____ Barry ■■■■■■ . HTLchigan "= T ■ . —-------------- Date--------------------- 19 Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops Funeral Chapels, Inc, hereby given tn 935 4th Ave, Lake Odessa, Mich 48849 Addrw (Funeral director or person acting as such) to dispose of body August 1 Signature. 1989 Mortuary Science Licensee) (Check one CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. Aut&r-C)__________ i9&s_ / — nn g - ^(StatejwhetherjBremated. burigd, stored, etc.) Place—T_1 & ( rt&riofcfai fAk (i/nrt # -?0______________ S______ Z. 0 / ^J£»metery or crematory) \ Signature—---------------------------(Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION I 1-26 5/84 BURIAL—TRANSIT PERMIT No._ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics ADAM ANSON FENDER Date of death Dec* 4. Full name of deceased Cause of death Place of death Aspiration pneumonia, hypoxemia (County) Method of disposal I Hastings Barry 19 89 Race white ________ Sex-M_ Age_Z9 (Township or village or city) Woodland Memorial Park Burial (Cemetery or crematory) (Whether burial, cremation, storage, etc.) ----------- ’--------------------------------------------------------------- 1 rnnntv APPROVED FOR CREMATION [ county Barry ' State ----- - awe _ Signature of Medical Examiner Michigan 19 Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver Koops Funeral Chapel to tiu*'t Lake Odessa, Michigan-------------- Address , ^Stmeral director or person acting as such) to dispose 6f bddygfs^id dece^sedT^ Date • .'(Ilf! ft heck one: Reamnr. Q[ Funeral Direaor. Dec. 7 --------- 19—82 0|%(ortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was_____________________________ on ^Ltc, 7_______ 19 (State whether cremated, buried, stored, etc.) Place P.t&f’ in / 6jQ________________ Signature /zV/V<r*^,<Cemetenf or crematory) 1-----------' (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-24 4/M Authority: Act 361 of 1979 and Act 299 of 1990 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL^-TRANSIT PERMIT Full name of deceased Cerebral Vascular Accident Cause of death Place of death _________________________________________ Hastings Twp. Barry (County) , . Rana (Township or village or city) White Sex_M_ Age_93 Woodland Memorial Park_______ Burial____________________ Method of disposal ——iMB^^^^^^^^^^^^^^^^^^^^^^Wheihc^urial^crematiwhstorage. etc.) (Cemetery or crematory) g Stgte Michigan I County-------= APPROVED FOR CREMATION Date 19----- Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels, Inc* Addrw 935 4th Ave* Lake Odessa, Mic(Funeral director or person acting as-such) 48849 to dispose ofj»etfy*of said deceajjtd. Signature, ‘7?^ (ChecFoneA □Qtegistrar. ®*TunerAOirector, / Date 19_89 October 4, Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE^BfcLOW __________ On Ocf </ 19 S2_ in J IamA o</44 6KK Body was Pl A iState whether cremated, buried, stored, etc.) Placed* ~ r 7 Signature ^^9 1 ‘ (Cemetery or crematory) (Sexton or person in charge) * This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B>26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION No--------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics ROBERT LUTHER BORN Date of death Sept* 30 19 89 BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics ’ ■ Full name of deceased Method of disposal •_____________________ Ionia Ionia (County) Race white ________ Se.x M Age, 73 (Township or village or city) _ Burial s Woodland Memorial Park State Michigan Barry I APPROVED FOR CREMATION ; (Cemetery or crematory) (Whether burial, cremation, storage, etc.) Signature of Medical Examiner tn * Date of death Sept*22f 19 89 BRANDT Ventricular Fibrillation Cause Of death Place of death ROBERT Date . 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given Koops Funeral Chapels, Inc. Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of bocb^oj said decease!. Signature (Check one: Body was Ry^istrar. s Date Sept * 25, |g89 QQ Funery Director zZ 50 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW --------------------------- on 192L? jn ^\ikl£(S (State whether cremated, buried, stored, etc.) Place-^Z^T" 7 Lo / y ^ 4 ^71 0 ffy/i ■ (Ccwtury or crematory) Signature 'tSexton or person In charge) f This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of riprpaged Cause Of death No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 ELIZABETH OLIVE BAKER Date of death Mar« 17 ,-ip 89 Myocardial infarction Place of death Hastings Barry Method Of disposal Rare . , . Woodland Memorial Park Burial (Whether burial, cremation, storage, etc.) (Cemetery or crematory) , „ SioVBO FOB CREMATION---------------------------- 1 <*■* . „ »U,. Signature of Medical Fvamine.r — Data., ----- ' 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops Funeral Chapel^rm Lake Odessa, Michigan hereby given tn (Funeral director or person acting as such) • to dispose of bod^of^said deceased. March 2Qj--------- 19 89 Date Signature (Check one: PfXeglstrar. FunentZDirector, Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE^BELOW 19^^- in ----------------------- • Body ~i (State whether cremated,^uried^stored, etc.) (Cffliatory or crernBt0,‘y) Place^4-i>^3i^t3fts0tC-^23dede3KiAt*i±^—X^^^fc.Signature-<2^ -------------------(Sexton or person in charge) •* This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton), -3^ JL ft (OVER) B-26 “ 5/84 ' * BURIAL—TRANSIT PERMIT THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Age 82 sex F White (Township or village or city) (County) No.__ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death Date of death EUGENE F. BARLOW RESPIRATORY FAILURE Place of death BATTLE CREEK CALHOUN (County) 19 89 12-24- __ _____________________ Sex M Rare WHITE Age 74 (Township or village or city) Method of disposal WOODLAND MEMORIAL PARK BURIAL (Cemetery or crematory) (Whether burial, cremation, storage, etc.) I Cnnnfv ^voumy---- APPROVED FOR CREMATION Stat* BARRY. state , MICH .. — Date 19 Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given WREN FUNERAL HOME_____________________ Addre<?s to HASTINGS, MICH (Funeral director or person acting as such) to dispose of body of said dec^ase^K y / Date Signature (Check one: Registrar. Funeral Director, gj DEC* 26__________ 19 89 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW $9 Body was—---------------------- on zw. (Stale whether cremated, buried, stored, etc.) - - in I . (Cemetery or crematory) Place ------------------ Signature z ______ f * (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/88 Authority: Ad 368 of 1971 aad Ad 299 of 1990 �BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics LARRY GEORGE VROMAN________________________ Date of death 2-25- Full name of deceased Cause of death 19 90 RESPIRATORY FAILURE Place of death BARRY Race_WHITE HASTINGS (County) Sex-M_ Age 32. (Township or village or city) Method of disposal BURIAL_______________________________ WOODLAND MEMORIAL PARK (Whether burial, cremation, storage, etc.) ___________ (Cemetery or crematory) ,--------------- State __MT ]_C°unly.----- BARRY APPROVED FOR CREMATION Signature of Medical Examiner Date . 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei to---------- AREN FUNERAL HOME HASTINGS, MI Address ___ (Funeral director or person acting as such) Signature (Check one: t) Registrar. Body was Place / e to dispose of body of said/iece^?ed. Q Funeral Director. FEB, 26 Date Mortuary Science Licensee) 19 90 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW J) on 7*^4 <3 7 19 _2» in (State whether cremated, buried, stored, etc.) sCsf? I (Cemetery or crematory) 7 Signature P (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). B*2tf 4/M Authority: Act 368 of 1978 and Act 299 of 1980 (OVER) / f) I >< ’ ;• ' .i/'Name of Fetus: MICHIGAN' DEPARTMENT‘OF PUBLIC HEALTH' •■■z/-.' '• • Failure^: provide' ' Office of'the-State Registrar & Center .for-Health Statlstio^f AM-^ .... ... non ----- s^.. n« 4 mo of not There tha^ SI,900.00 ’or b<?th. V'*’ <• b? Fetus»of CE’Ov ^;IU F • ■ iFeius was -delivered dead ' >•' ‘ *;• : ^g,S^,0Tdnature:. (CowIM '•••• Method of fjna| disposition (check, one): * . CQ/^urial >• •■-.'•'i, : O .Cremation. ’: ; ■ :(Townehip o> Village..o(,£ity) O Storage • • -O .Donation ’{.'0, Other ?■- a °zr Z'<f■□.v' APP^OVED fOR; CREMATION. BY: Date . " (Signature of . Medical Examiner) ■ AUTHORIZATION . FOR FINAL DISPOSITION OF SAID FETUS: IS^d(VENt BY: .Name. r meral Cfiapdls^ Inc . *_ P INSTITUTION t^ECTOR-'^ AGENCY- AUTHORIZED .TO. ACCEPT- Djp.NATED Gary ■ R < ’'(CHECK'ONE)- [ testae '■ Signature \ of; .Mother • At.-i : • K '■■ Vi V Signature of Father /•* •“% Xi Date, -^{MORTUARY? SCIENCE LICENSEE'OR >"’ * * r * •. Final - Disposition was on , Mav 10, t* . 1 :; -W6b<nmy| ^wp.: ’ 1 - •’ • '»’" '• ■’’} ■ ’ *• *'•' ? *■’» • t I. ' , .' ' in 90 in ■ - Woodland Memorial- Park ■ 1 1 ’’ 1* . /V; ■ > . ?. •'*—3 ' . ......................... IC.moIuu <^»stonaturec____ _______ M PrMiii'tAAi LwTe . _____ ___ .....„„ BODIES �State of Florida, Department of Health and Rehabilitative Services, Vital Statistics ----------- APPLICATION FOR BURIAL - TRANSIT PERMIT | A. (Type or Print) 1. Name of First Deceased j Middle MAE EDNA City, Town or Location 2. Place of Death < County y Lake Last DATE OF TOWNS DEATH Name of Hosp, or lnst Leesburg Medical Examiner 3. Name of Medical Certifier 5. Check ., Appro­ priate Box a 1123 West Main St. Leesburg, Fl. 787-7850 904/787-4343 173 was contacted on 2/26 *•! ________ within 72 hours after death. He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that he------------------------------------ will complete and sign the medical certification of cause of death. was contacted on . He/she verified that Medical Examiner, will complete and sign the medical certification. Removal fr(X | frQm state______ | Instate cemetery/ orematortr - name/county: F.E. No./Reg. No. 7. Funeral Director/ ] Donation Date Signed Feb. 27, 1990 1125 Joe H. Sellers BURIAL - TRANSIT PERMIT v Phone Number Fla. Lie. No./Reg. No. Phone Number (Area Code) Dr, Sarmiento 6. Place of Final Disposition: BkocxxsspKXdr Leesburg Health Care Center The medical certification has been completed and signed. A completed certificate of death accompanies this application. b c Year (If neither, give street address) Address Address Beyers Funeral Home Day Feb. 26,, 1990 1027 W. Main St., Leesburg, Fl. Physician Cesar F. Sarmiento, MD 4. Name of Funeral Home/ Month , .cno Permit No.l 73-4508 Permission is hereby granted to dispose of this body. A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Registrar of the County in which death occurred. No extension of time for filing the death certificate requested. Registraror , Date. o 07 on ?teCWa<& Subregistrar Signature Issued: -------------- Due: ..■’J-d-jU-------------- AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA C. Signature , Medical Examiner . Date or ----- ^ Medical Examiner,, gave authorization by telephone to __________________________________________ Funeral Director/Direct Disposer. Date The Medical Examiner’s approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is required for all cremations. CEMETERY OR CREMATORY Woodland Memorial Park Place of Disposition Woodland , Michigan Methods of Disposition: 0 BURIAL CREMATION STORAGE Date of Disposition March 2, 1990 OTHER (Specify) Signature of Sexton ) or Person-in-Charge) . This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 10 days to the local HRS County Public Health Unit in the County where disposition occurred. HRS Form 326, Feb 89 (Replaces Oct 87 edition which may be used) (Stock Number 5740-000-0326-2) �PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased CARCINOMATOSIS KALAMAZOO Cause of death___ Place of death KALAMAZOO WOODLAND MEMORIAL PARK ____________ BURIAL------------------ - ---------------- (Cemetery or crematory) (Whether burial. cremation, storage, etc.) " "— APPROVED FOR CREMATION I County 1990 s&e_ a£> rathite (Township or village or city) (County) Method of disposal No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and .Center for Health Statistics LINDA Rt THOMPSON Date of death MICH State BARKT Signature of Medical Examiner— A certificate of death having been filed as required by the laws or regulations of this> state, permission is hereby give. WREN FUNERAL HOME Address lo HASTINGSjMI------------- ----------------- (Funeral director or person acting as such) to dispose of body of said deceased Signature twp APR, 30 19.90 Science Licensee) Body was - CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW CEMEJI____________ 19 1^. in J/AaiD (Cemetery or crematory) on . (State whethe^cremated. buried, stored, etc.) t Signature Place piton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/M Authority: Act 361 of 1978 and Act 299 of IMO THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION T BURIAL—TRANSIT PERMIT No----- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics n rj . rATMRRTNRC RAIRIGH______________ Date of death —L2——19_2_C Full name of deceased._______ GAI nbK 1 d—u_a—kn a r a . — Cause of death________ CHRONIC—RENAL—FAILURE---------- --------------------------------- Place of death_____________ HARRY_____________ HASTINGS. TWP_ Race-------WHILE- Sex-EL Age JU ' ’ <cU. „OTvill>“or Clly) WOODLAND MEMORIAL PARK. Method of disposal------------------------------------------------------------------------------tce«.n</™y> --------------------------------------------------------------------------- - r»»ntv_ BARRY - State----- MJ-------------APPROVED FOR CREMATION 1 .. ___ _______________ Date--------------------- - 19----- A certificate of death having been filed as required by the laws or regulations of “10, permission is hereby giver tQ WREN FUNERAL HOME____________________ ___ Address------------- HASTI GS_»-------------------------- (Funeral director or person acting as such) to dispose of body of saicLdeceased. z ___________ n<» DEC- *__________ - 1£°- CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE Body was • 19 ------------------- on . (Stale whether cremated, buried, stored, etc.) 'fl _. A/fA?AV f '______ Place Sjgnature--------- ~ This iJSrufinust be endorsed by the sexton ftf^y tfiejunfrafdffretor or Mortuary Science licensee where there is no sexton , (OVER) B-26 4/81 Authority: Act 368 of 1971 and Act 299 of I960 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No--------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics FRANK E. STANGER-------------------------------------------- Date ofdeathNov. Full name of deceased Place of death Grand Rapids ---------- Race White-------- SexJL Age 63 ftoodland Memorial Park___________ Kent------ „1ir 4O1 (Township .r village or cuy’ DUlld-L------------- -------- .------ -------------------- — (Whether burial, cremation, storage, etc.) ..................................................... Method of disposal---------------------------------------------------------------------- 1------------------------- 1 Cnnntv APPROVED FOR CREMATION L (Cemetery or crematory) State Michigan------ Barrv — . Signature of Medical Examiner------------------------------------------ —---------------------------------- Date 19— A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei t0 Lake Odessa, Michigan Koops Funeral Chapel (Funeral director or person acting as such) to dispose of bock? of>aid ✓ Date—^ov*—1_2_>------------------ 19-20. Signature ■^^^^^^*^(Check one; ^jjlpgfstrar, Body was — jp Funeral Qjrector. Sr Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW ______ on /Z19 in buried, stored, etc.) I Placed T Signature /Cemetery or crematory),> / ' 7 V(° . . ' " , (Sexton or person in charger (/ This permit must be^naorsea by rhfc sSxton (or by thefuneral director or MortuaryScience licensee where there is no sexton). (OVER) 4/88 Authority: Act 3(8 of 1971 and Act 299 of 1980 BURIAL—TRANSIT PERMIT THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION 9,...„i990 Acute and chronic anoxic encephalopathy ------------------------------------------------------- Cause of death No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics THOMAS JON SWIFT_________________________ Date of death 1-8t---------- 19_9jQl Full name of deceased Cause of death SUFFOCATION____________________________________ Place of death WOODLAND TWP- BARRY _________________________________ Race Sex -M— Age-11 WHITE (Township or village or city) (County) Method of disposal---------------------------- BURIAL--------------------------------------- WOODLAND MEMORIAL PARK---------(Whether burial, cremation, storage, etc.) (Cemetery or crematory) [County---- APPROVED FOR CREMATION BARRY - State .. MI Signature of Medical Examiner- Date- 19 .. A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver to WREN FUNERAL HOME_________________________ HASTINGS. MT Address. (Funeral director orjserson actions such) to dispose of body of said/lec^Ked. ’ <■ Date Signature-----------(Check one: Body was Z?A J l] Registrar. Funeral Director, JAN, 9 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW C>\^x»rJ) on // 19 in V" :_________________ (State whether cremated, buried, stored, etc.) Ptoc/3b**j£ f&r *7( 19-20. Mortuary Science Licensee) (I — . (Cemetery or crematory) Signature —_________________________ (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/M Authority: Act 3(8 of 1978 and Act 299 of 1980 �t h i s p ERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased Cause of death-___ Carr.i nnma of Lung____________________________ ____ _ _ __ __________________________ Grand Rapids Rftce_white K^t Place of death Method of disposal 8py AgP84 M (Township or village or city) (County) Woodland Memorial Park Burial (Whether burial, cremation, storage, etc.) (Cemetery or crematory^ -n , FOB CREMATION--------------------I ** Date— Signature of Medical Examiner 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops-Funeral-Chapels,Inc-. hereby given to Address Lake OdessaP Michigan (Funeral director or person acting as such) > to dispose of bodv^of^said deceased. Feb, 2, ------------------------------ Date Signature— jPheck one: }£] Funeral mrector, JUvistrar, 19.20— JQ Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW on__ 19 ?0 Body was—SaaZLUlAz (State whether cremated, buried, stored, etc.) Place_£W * $ 97 * in ** P A U ) Signature -lv- (CTiiistnji or crematory) (Sexton or, person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) 1*26 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION no. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 RAYMOND GILBERT McT.EOD___________________ Date of death Jan y 30 19 90 5/84 BURIAL—TRANSIT PERMIT Full name of deceased Cause of death No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 CLTFTON JAMES SAWDY Date of death Jan » 23-49 90,, Massive Stroke Place of death gev M Hastings R<M,ft. White Barry Age-.?* . Burial_______________________________ Woodland Memorial Park Method of disposal ■■ ■■ County ■ 1 uouniy—T Signature of Medical Examiner (Cemetery or crematory) ' (Whether burial, cremation, storage, etc.) - ■ APPROVED FOR CREMATION Ionia' —— gtete Michigan 19 __ _____________ __ Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels,Inc■ Address Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of body oysyd deceased^ Signature- 4, X(Check one: Q R^istrar, . January 26. jf) Fun/ral Dirt^for, 19-90 QQ Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was .on (State whether cremated, buried, stored, etc.) Place PA-rft" & Y J or crematory) Signature—---------------------------- 3^1*/ (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). if B-26 5/84 ( <0 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased RUTH E. HIBBARD_________________________ Date of death — Cause of death ___ A.S.H.D. Place of death KALAMAZOO KALAMAZOO SexJL Age®! RacP WHITE (Township or village or city) (County) BURIAL____________________________________ wnnDT.ANn 'HRMnRTAT, park Method of disposal (Cemetery or crematory) (Whether burial, cremation, storage, etc.) BABBS.. | County APPROVED FOR CREMATION Signature of Medical Examiner State .MICHIGAN 19 _________________ Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby give Address 5933 S, WES TNEDGE, KALAMAZOO, MJ to—TRIIESnAT.F-ANSFJ.L 'FUNERAL HOME (Funeral director or person acting as such) to dispose of body deceased. n... APR 10 1930 Signature (Check o ;nce Licensee) CEMETERY OR CR ATORY AUtfiORITY SHALL FILL OUT SPACE BELOW !&C)______________ on // 19 in Body was /p. <State whether cremated, buried, stored, etc.) fML /fa (Cemetery or crematory) (Sexton or person in charge) ' This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 BURIAL—TRANSIT PERMIT THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION 19 9C 4 —8 “'‘ _ No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death JOHN HARRY LONG Date of death June 6 r J9_90 Acute Myocardial Infarction Place of death Barry (Township or village or city) Burial Method of disposal Sex JL Age_£2 Race white Hastings_________ (County) Woodland Memorial Park-------------------(Cemetery or crematory) (Whether burial, cremation, storage, etc.) State, Michigan I Count* APPROVED FOR CREMATION ;_______________________________________ Date 19 Signature of Medical Examiner— _ A certificate of death having been filed as required by the laws or regulations of this state; permission is hereby given to. Koops Funeral Chapels, Inc, ' Address Lake Odessa, Michigan ✓funeral director or person acting as such) to dispose of boc^/opraid dece^se^^^ Signatur&gg^S^-^C^^— • (Check one; Q^tegistrar, QJ Funeral Director, Date.___ June 8, CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW ______________ on fo- y 19jn Body was (Stale whether cremated, buried, stored, etc.) Place-F/z>T~ £ SLnf 19-20. Mortuary Science Licensee) . -4 _________________ Signature I . /? [fZtxaxxvrt or crematory) ---------------------------------f I (sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). B-26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 (OVER) �BURIAL-TRANSIT PERMIT No._ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Glenna Colette Greiner__________________ Date of death 11-11- Full name of deceased Cause of death RESPIRATORY FAILURE BARRY Place of death Race HASTINGS WHITE sev FE Age 83 (Township or village or city) (County) Method of disposal BURIAL WOODLAND MEMORIAL PARI . (Cemetery or crematory) (Whether burial, cremation, storage, etc.) ... BARRY..- (.County APPRQVFn FQff rPFMATTQN State . .MI .... . _ Date 19 Signature of Medical Examiner to 1990 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver WREN FUNERAL HOME Address HASTINGS, MI (Funeral director or person acting as such) to dispose of body of saiddeetased. f Date. Signature. (Check one: (3 Registrar. Q Funeral Director, 19 90 MW• 11 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was (Sla . on .... cremated, buried, storj Place-ZtZELi: or crematory) _________ Signature by*?he sexton (or by thefuneral director or Mortuary'ltcience licensee where there is no sexton). This permit must (OVER) B-M 4/18 Authority: Act 368 of 1971 and Act 299 of 1980 BURIAL—TRANSIT PERMIT Full name of deceased no MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 CARL H. HEISE----------------------------------- .-------------- Date of death. JQA-22— 19_2Q— Cause of deaftieuinQnia--------------------------------------------------------------------------------------------- ;__ __ _______________ Place of death Kent Grand _Rapids Race_X_. - Sex M . Age.ffi.. (Township or village or city) (County) Method of s Burial disposal , Woodland Memorial Park (Whether burial, cremation, storage, etc.) ————————■■■APPROVED FOR CREMATION —-i I county y (Cemetery or crematory) Barry______________stat* Michigan ■■■ ~ Signature of Medical Examiner Date 19-------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given Koops Funeral Chapels, Inc. AdHrp-., Lake Odessa, Michigan (Funeral director or person acting at such) to dispose of body efts^id dece$sedL sivn.t„rp (CMeck one: Body was Bygl»tr»r, S ------- ------------------------ n.u January 31, Funeral Direoor, [JQ Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW 0 on — 19 in <»a^ (State whethuc cremated, buried, stored, etc.) Plarft 19 90_ I * (Cemetery or crematory) -------------------- Signature,-------------------------------(Sexton or person in charge) This permi^S^^Kndorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 �O iA i L (This copy must accompany body to final destination) REGISTRAR'S DEPARTMENT OF HEALTH SERVICES • OFFICE OF VITAL RECORDS FILE NO. DISPOSAL- TRANSIT PERMIT tnFMTiFICATirNJ iwun i it ivn i i vn OF DECEASED a. Hnsf NAME OF DECEASED 1, DATE OF DEATH LaVeme PLACE Q CREMATION AND OTHER (SPECIFY) FUNERAL HOME », Sunset Vista-Euneral Home OTHER DISPOSITION C. CITY ANO STATE Yuma, Ariz. lOATE SIGNED n 4 April 1990 ■RTeY C. CITY AND STATE , . _ a boh Ess' Woodland Memorial Park Ite Rd Woodland Michigan 12 13. IN ACCORDANCE WITH THE LAWS OF THIS STATE ANO THE REGULATIONS OF THE STATE DEPARTMENT OF HEALTH PERTAINING TO DEATH CERTIFICATE ANO THE HANDLING OF OEAD HUMAfr»*<MAINS/AUTHORI ZATION IS HERESY GIVEN TO DISPOSE OF THIS BOOT IN THE MANNER INDI CATED. REGISTRAR'S SIGNATURE T | /^-*-|REG. DISTRICT lOATE SIGNED ““ 4 April 1990 ■ 4> (JjL- A/-0C72CEMETERY OR CREMATORY BODY WAS: fr~] BURIED A. NAME / ' / » ie.Woodland Memorial Park [~*~| CREMATED DATE OF DISPOSITION 17 LJother DATE RcV’o. IN 5TA1 E OFFICE STATE C. CITY ANO STATE B. STREET ADDRESS Velte Rd. Woodland. Michigan CEMETERY MAN AGER*S^JGNA TURE April 12, 1990 r—'(SPECIFY) VS-7 REV. 8/88 4. Whi f“P —“triiw 1 a. COUNTY 11357 E. 40th St. RE 10. A, NAM OF BODY REGISTRAR USE zMale RACE OR COLO B. ST. ADDRESS REMOVAL PLACE OF DISPOSITION AGE 369 Cardiorespiratory Arrest BURIAL FOR DISPOSITION ——U SEX (MUST SC COMPLETED IFBODY IS SHIPPED OUT OF STATE. MOVED SY COMMERCIAL CARRIER. OR A DEATH I^ROM CERTAIN DISEASES) MANNER REGISTRAR’S AUTHORIZATION Clum A. TOWN OR tlTY p>4 April 1990______ e._______________________ Yuma_____________ Yuma_________ Arizona CAUSE OF 7. A M DISPOSITION . George_____ OF DEATH 20> ---------- REGISTRAR'S SIGNATURE * ~ TITLE 22 A. ► 22 B. 21. CEMETERY MGR.: MAIL TRANSIT COPY IN 10 DAYS TO VITAL RECORDS. P.O. BOX 3887 DEPARTMENT OF HEALTH SERVICES. PHOENIX. ARIZONA 85030 BURIAI^-TRAN SIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death MYRNA J. FINNIE Date of death 1990. ____ METASTATIC CARCINOMA Place of death Race WHTTF, HASTINGS TWP. BARRY Sex .EE- AgelA (Township or village or city) (County) Method of disposal WOODLAND MEMORIAL PARK------------------ BURIAL (Whether burial, cremation, storage, etc.) (Cemetery or crematory) State BARRY j County APPROVFn FOR cremation Signature of Medical Examiner Date MT ... 19— A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei to---- WREN FUNERAL HOME HASTINGSr MI Address — (Funeral direciM* or person acting as such) / to dispose of body of said deceased* Date Signature---------(Check one: Body was------- Q Registrar, 1950. APR. 5 Funeral Director, Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW on 7 191*- in /La (State whether cremated, buried, stored, etc.) Place-------- p /fi I ----- >3 ’ I _r~ (Cemetery or crematory) Ak ---------------------- — 35_____________ Signature f cSexton or person tn charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). B*26 4/M Authority: Act 363 of 1971 and Act 299 of 1990 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death __ Date of death Feb. 14 f ELTON LEON VANDECAR Place of death Barry Woodland Method of disposal SexM white Age 66 (Township or village or city) . (County) Woodland Memorial Park Burial (Cemetery or crematory) (Whether burial, cremation, storage, etc.) | County APPROVED FOR CREMATION State-Michigan Barry Signature of Medical Examiner Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei to —^P°PS Funeral Chapels Addre.ss Lake Odessa, Michigan (Funeral director or person acting as such) . - to dispose of body^ot said deceased/"^ S Date (Check one: Q CEMETERY February 23, 1991 g^Monuary Science Licensee) tcior. ATORY AUTHORITY SHALL FILL OUT SPA' Body was jc (Cemetery or crematory) person in charge) This permit must be endorsed by the sexton (or *e where there is no sexton). (OVER) B-26 4/M Authority: Act 368 of 1978 and Act 299 of 1980 BURIAL—TRANSIT PERMIT THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION 19 91 Carcinoma No._----- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of rWh Place Of deMh , .u~. OLTVE ELIZABETH VANDECAR-------------------------- Date of death Congestive heart failure Grayling^---------- Race white------ SexZ— Age 83 Woodland Memorial Park Crawford , 'Coumyt Method Of disposal--------------------- Burial , May 16t.ift_9J ---------------------------------------------------------- ------------------- — <TowMi.ip.. vin.»« o> d.y> cremi|ion, >(arMC eK1 - (C.m«ry •rcrmwoO'. ---------------------------------------------------------- 1 County Barry State . Michigan, APPROVED FOR CREMATION l__————————— Signature of Medical Examiner------------------------------------------ ------------------------------------- Date tn A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby give. Koops Funeral Chapels, Inc. ____ Address Lake Odessa, Michigan,-------------(Funeral director or person actinias such) to dispose of body ofjiakl deceased//C/ ✓ , Stature —^g^^^^^^^^crtlD.^t^jQ^^^SdeXLicensee) c. __________ nMe May 18, - --------- 191_ CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW on ' Z.(State whither cremated, buried, stored, etc.) a '-J t . J . «. Place ^3^0 r'5' —<-*gJffsignature (Sext$7^)rper$on charge) Body was This permit must be endorsed by the sexton (or by thefuneral director or Mortuary ScienceUMsee where there is no sexton). (OVER) B-26 4/M Authority: Act 368 of 1971 and Act 299 of 1980 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No.. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Date of death Keith Vroman Full name of deceased. Sept-3 19—85 ___ Cause of death Place of death________ Barry_______________ Hastings ____________ t Race__ W_________ Sex___ H_ Age.. 57 (Township or village or city) , (County) Method of disposal , __________ Burial_______________________ ________ Wood land Memorial Park (Cemetery or crematory) (Whether burial, cremation, storage, etc.) Signature of Medical Examiner. hereby given e I County-------------- --------------------------State-------- 1C ian APPROVED FOR CREMATION 19. Date. A certificate of death having been filed as required by the laws or regulations of this state, permission is KooPs Funeral Chapels,Inc. A<Wrw<, ‘ Lake Odessa, Michigan m (Funeral director or person acting as such) to dispose of body>6f spid deceased/^ a S S i gn aturg/~^w4— (Check one: Zj Rei Funeral Irectg'/'jT _____________ Data 19-25. Sept ♦ 5 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. .01 (State whether cremated, buried, stored, etCr)^ v / _____________19£j? in (Cemetery/ Pl|]^Signature., / crematory) _ (Sexton or person In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 �THIS PERMIT MUST ACCOMPANYREMAINS TO DESTINATION BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 TREVADON 0. CULLER _ Date of death Jan 20 Full name of deceased Cause Of death No. Place Of death Muskegon ' (County,) Muskegon Rwrft (Township or village or city) , . Burial_____________________________ Method Of disposal io91 ; Chronic Renal Failure (Cemetery or crematory) , Barry Signature of Medical Examiner—— F . AgB 85 Woodland Memorial Park (Whether burial, cremation, storage, etc.)n —------------------------------------------- --------------------------- 1 APPROVED FOR CREMATION I White ----- , Michigan ■■■„ Stat^ _____________ Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission h hereby given tn Koops Funeral Chapels, Inc, Address 935 4th Ave, (Funeral director or person actihg as such) odv oKsaid deceased .to dispose Signatur Date (theClT one: Lake Odessa, MI 48849 January 24, 19.91. Mortuary Science Licensee) CEM ATORY AUTHORITY SHALL FILL OUT SP 19 fin. Bod; .(Gemetery or crematory) Place Signatur \J (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) I B-26 5/84 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIALr—TRANSIT PERMIT No---------------------------------MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics . FLORENCE J. ECKARDT Full name of deceased------------------------- ------------—------------------ ---------- ----------- Date of death Nov- 2UJ-19Z£ Cause Of death Congestive heart failure----------------------- - ----------- -- -------------------------------------------------- PhcenfdeMh Charlotte Eaton Method Of disposal i -------------- BtirULte, Kriri. cremation. Monge. Race, white SexK- AgeSfi. w cresyl Park ' -----------WoodianiCemelenr d Memorial --------------------------------------------------------------------------- 1 County Barry — State Ml rhi gan — APPROVED FOR CREMATION •----------------------------- ----- “ Signature of Medical Examiner------------------------------------- -------------------------------- t0 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei Koops Funeral Chapels, Inc, Address Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of body oLsaidrdeceas^dr X Signature Body was (Chfcfc one: Reyttfayr Jp Funeral Director. -------- ------------------ Date ^onuary Science Licensee) November 23,---------- 1921 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Z? on g.3_ 19 V- in toiate whether cremated, buried, stored, etc.) (Cemetery or crematory) r Place_^TAo^ 5--------— Signature-------------------------------------------------- ---------------------------------------------------------< n (Sexton_or.ocrson in charge) * This permit must be endorsed by the sexton (or by thefuneral director or Mortuary ScienceTicensee where there is no sexton). B-26 4/18 Authority: Act 368 of 1978 and Act 299 of 1980 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Keith Albert Ayres Date of death Full name of deceased Cause of death______ AAA—flpf"f" | C—fln€Ufl.5f23---------------*_\jl Method of disposal r (1 ownship or village or city) (Countyf Rnrial-----------------Wnnd land CeniP tftxzy. (Whether burial, cremation, storage, etc.) ] County APPROVED FOR CREMATION 19 {- (Cemetery or crematory) Barry Signature of Medical Examiner 9/25/ ----- Race— Place of death___ ------------------------------------- Marniifttte.— ■ State — M -i r.h i ga n. ________________ Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei tn Addr^s Swanson-Lundquist FH Marquette, Michigan (Funeral director or person acting as sti| :h) to dispose Signature body of said deceased. SePt' Date (Check one: Registrar. 27 > 19_?_J O Fun/r^l Director?*''-Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW -------------- on 19 54 in -111fiOeL&ui Body was Place-jX^A.iV/ £----- . AL 6 3, >_________ Signature—___________ ___ (Sexton or person in charge) v i ms permit must be endorsed by the sexton (or by thefuneral director or Mortuary Sciencelicensee where there is no sexton). (OVER) B-26 4/M Authority: Act 368 of 1978 and Act 299 of 1980 TRANSIT PERMIT BURIAI THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics t Full name of deceased. k71Ao^il CotVP.lAQ Date of death ^pci I Cause of death Place of death____ Method of disposal Sex Psr (County) () Age (Township or villager city) (Cemetery or crematory) (Whether burial, cremation, storage, etc.) State U APPROVED FOR CREMATION 19— Date Signature of Medical Examiner-. A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby give to—iCi* Fungfld—H^orw Address.,l4<*«S ------(Funeral director or person acting as such) to dispose of body of said deceased. . Signature (Check one:lj~l Registrar. Funeral Director. I___ LSl Date Q^Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACg BELOW Body was----. (Slate whether cremated. ------ on ~ etc.) . Signature /7 , J » (Cemetery or crematory) ———----- ------ (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Sciencelicensee where there is no sexton). (OVER) B-26 4/M Authority: Act 368 of 1978 and Act 299 of 1980 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No. Full name of MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Paul Franklin Fisher Sr_.------------ Date of death May..27i9-S— Cause Of death Parkinson.!s Disease------------------------------ ---------------------------------- Eaton------------------------- Sunfield Place of death Race White Sex-M_Age-21- , (Township or village or city) (County) .r~ --------------------------- ——--------------------------------------- - County Harry------------------ state Mi rh 1 gau-------APPROVED FOR CREMATION I--------------------------------------------------------Signature of Medical Examiner---------------------------------------------------------- ------------------ Date--------------------- 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given Rogi e r F (Funeral di/ect e r a 1 Home Addreww or person/acting as such) to dispose of body of said dec/ase ______________ Date-Hay Signature__ (Check one: Q CEMET/ER 193 Jackson St. Sunfield, MI 48890 QCMortuary Science Licensee) .3 0 19-S2- OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was.------- - ------ on <State whether cremated, burled, stored, etc.) (Cemetery or crematory) Signature. -Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 (OVER) 5/84 �MSMBER; ' MICHIGAN CEMETERY ASSOCIATION AMERICAN CEMETERY ASSOCIATION NATIONAL ASSOCIATION CEMETERIES NATIONAL CREMATION ASSOCIATION INTERNATIONAL CREMATION FEDERATION NATIONAL LOT IXCHANOC - INTERNATIONAL LOT EXCHANGE PHONE C616) 949-0660 4341 CASCADE ROAD S.E.. GRAND RAPIDS. MICHIGAN 49506 MEMORIAL PARK AND MAUSOLEUM Name of Deceased.......... Alf rgd....GQrd.Qii... Hong Hastings, MI Place of Death. . Age . 74 ; Date of Death. „J.an.uaxy....l9.4L....1.9..8.5 Date Received. January 21, 1985 a* n January 21, 1985 ; - Date of Cremation ; e Barry County i Funeral Home ; "Destination of Cremains Cardiorespiratory failure Cause of Death. Koops Funeral Chapel, Inc. Funeral Director. BURIAL—TRANSIT PERMIT z o £ & w 0 ©I h Lake Odessa, MI;. No MICHIGAN DEPARTMENT OF PUBLIC HEALTH KENNETH VON MAKLEY Full name of dwawi Date of de»th June 141985. Acute Myocardial Infarction Cause of Place of death Barry Method Of di^i <C""tgurail . Hastings_____________ Race white Rev M AgeZl— O'or «*> Woodland Memorial Park APPROVED FOR CREMATION---------------------------- 1 County Signature of Medical Examiner -State • — - ------ Michigan----- ■ Data— ■ ■ 19 ■ A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to. A.ddrw Koops Funeral Chapel / Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of body, Signature’^^i— (Check "one co P * <-—<7_________ _ Date. Body was co »-» 19.85 CEME^RY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW 19. CA W a- June 17, fY Mortuary Science Licensee) Signature^ 'ematory) -g. (Sexton or person In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). <0VER) Wx �BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH RUDY T. OTHMER____________________ ___ .— Date of rf**th Pull name of deceased Myocardial Infarction Barry Hastings Rare Cause of death Place of death Method of disposal June 1^9^ _ White ______ Agp 92 M Burial______________________________Woodland Memorial Park (Whether burial, cremation, storage, etc.)— (Cemetery or crematory) . . APPROVED F0E CREMATION---------------------------- ■ . Signature of Medical Examiner ■ ■— ■ ■ - Date 19 A certificate of death or fetal death having been filed as required by the laws or regulations of this state, permission i hereby given tn Koops Funeral Chapels, Inc, 935 4th Ave. Lake Odessa, M: (Funeral director or person acting as such) n Body was ARRAQ CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW ______ ,.A,/^ V 19_2A in X -.on.£jn / (Cemetery or crematoryYD (Vi,* (State whether cremated, burled^stored, etc.) Place—<2? 7 0 ------------- signature— ^y**4Sextonorperaon In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science Heen.es where there ic n texton). B-26 BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics CLEO MARIE SAWDY Date of death Sept, 4 Full name of deceased M* Cause of death Place of death 1991 _______________________________________________________________________________ Battle Creek Rare White Calhoun Method of disposal Srx F Age 87 Burial_______________________________ Woodland Memorial Park Cemete (Cemetery or crematory) (Whether burial, cremation, storage, etc.) I rmmtv Barry |.e°unty APPROVED FOR CREMATION State Michigan 6 Signature of Medical Examiner-------------------------------------------------------------------------------- Date 19 1A A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver Richard A. Henry Funeral Home Inc, Battle Creek, Michigan---------------fFuneral director or person acting as such) to dispose of body oP said deceased. /O_ / / \ / . _______ Date (Check onX^D Registrar. Funeral Director. September_4---------- 19_91 ^Mortuary Science Licence) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SP^95 BELOW z „ on Sa*lLM_ ■»-*)■ (State whether cremated, buried, stored, etc.) . r. ai. t A VtaeaJnJLce-t-f ™ S|8nature Spy** --------------------- Bod,... This pennit must be endorsed by the sexton (or by thefuneral director or Morluaty SciencHtCtnsee where there is no sexton). B-M 4/M Authority: Act Ml of 1971 and Act 299 of 1910 (OVER) �BURIAL—TRANSIT PERMIT No._----- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Mswrf^ Cause nfcWh GAROLD R. McMILLEN--------------------------------------- --- Date of death Dec, 20. ,<&_ Pneumonia-------------- ---------------------------------------------------- - ---------------------------------------------- Hasti ngs Barry Place of ---------- Race white-------- SexM— Age 86. (Township or village or city) (County) Method Of disposal_____________ Burial ------ ... Doylz ----------------Wonri1 ------------------------------------------------- Barry APPROVED FOR CREMATION ParJc-------- State .. Michigan L——- --------------- - Signature of Medical Examiner----------------------------- ------------------------------------------------- T^afr* A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby give I-ake Odessa, Michigan----------- Address- Koops Funeral Chapel Io (Funeral director or person acting as such) to dispose of bod/ of,said decease^. n n?n» December 23, 19_z rwit^TDinec^— Signature S CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW a4?z>Z on - 19 i-L in . Body was ? fl. This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science^ee where there is no sexton). (OVER) THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION B-26 4/M Authority: Act 368 of 1578 and Act 299 of 1980 BURIAL—TRANSIT PERMIT No------------------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 qf 1980 Full name of dyMyd. Richard Kicnam— — —--------———— v Theod ore Morgan il —— Date of death Hepatorenal syndrome------- ------------------------ cause Of Method Of disposal . (Whether burial, cremation, storage, etc.) "" --------------------------------------- —-------------------- 11 County ”Ba rry APPROVED FOR CREMATION ---------------Signature of Medical Examiner---------------- - --------------- ----------- " qi 5-2g—19------- __------------- ------------ -- (Cemetery or crema^j^-^ i g aH — ------State 19 ___________________ Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to. Pray Funeral Home, Inc.A401 W.. Semi nary (Funeral director or pe Signature. -------------------- - Body was— . .JKZ4LCA f - Place. TLaT S' 48013 19. ortuary Science Licensee) Y AUTHORITY SHALL FILL OUT SPACE BELOW /---------------- on-f (State whether cremated, burled, stored, etc.) MX --------------------------- - Date. Funeral Dlr -(J.—---------- CEMETERY OR CREMA Utlcl£XOtt6 / g aa such) g aa such) to dispose of bo ____ 19 -------1 . (x Cemetery or crematory ) AaT^A/A----- signature<-> (ftexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Scien^nsee where there is no sexton). B-26 5/84 (OVER) �BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics ^ean Kelley_______________________________ Date Full name of deceased Carcinoma of the lung with metastases Cause of death Place of death _______ Rare white Grand Rapids Kent Sex M Age 83 (Township or village or city) (County) Burial________________________________ woodland Memorial Park Method of disposal (Cemetery or crematory) (Whether burial, cremation, storage, etc.) Hieblgan ] <*■■? ^y APPROVED TOR CREMATION Date Signature of Medical Examiner to Aug.—18 t J9_9j --------------- 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei Koops Funeral Chapels, Inc. Address Lake Odessaf Michigan / (Funeral director or person acting as such) to dispose of b<^of said decSasecf?) 'jr ' Signatur^?^>^^^Z (Check yife: ------- ------------------------- Date J^istrar,Funeral JJirector, 19l9I August 21, Mortuary Science Licensee) cSmetery or crematory authority shall fill out space below Body was . on PlaceyUrff ft in 2-2 (State whether cremated, buried, stored, etc.) Cl * (Crmrteiy r>r crematory) ’ ZoTVgrt___ - Signature WSexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Sciencelicensee where there is no sexton). (OVER) B-M 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 BURIAL^—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased OGAL JASPER JORDAN[ Date of death Nov, lf Cause of death Subarachnoid hemorrhage Place of death Ingham 19 91 :_______________________________________ Lansing Race white $ex M 56 (Township or village or city) (County) Method of disposal Woodland Memorial Park Burial (Whether burial, cremation, storage, etc.) --- ---- --- ------—"------------------------------------ 1 (Cemetery or crematory) * Barry rnnntv | county APPROVED FOR CREMATION g£:c ( Michigan =. .______ Date 19 Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei tn Koops Funeral Chapels, Inc. Address Lake Odessa, Michigan Funeral director or person acting as such) to dispose of bo of said d ed. Date Signature heck one: egistrar. nor. November 4, Mortuary Science Licensee) 19.21 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was----- jSjAUi&eL----------------- on _ \9 $4- in (State whether cremated, buried, stored, etc.) Place.ycUaV-5------- 7^ / 6 A? /Cemetery or cremt cL- Signature * ___________ V (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Sciencetl&niee where there is no sexton). B-26 4/88 Authority? Act 368 of 1978 and Act 299 of 1980 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of d*ce»ked Congestive heart failure, acute______________________________________ Cause of death Place of death Barry Method of disposal Smc F Hastings rbpb white Agp 82 (Township or village or city) (County) Burial_______________________________ Woodland Memorial Park (Whether burial, cremation, storage. etc.) _ (Cemetery or crematory) Sf. fficWBan^ Barry-------------- APPROVED FOR CREMATION---------------------------- |C~,., —_________________________________________ Date Signature of Medical Examiner 19 A certificate of death having been filed as required by the laws or regulations of this state, permission it hereby given tn KooPs Funeral Chapel Address Lake Odessa, Michigan (Funeral director or person acting as such) id deceased. to dispose of body of .. J J Signature. (Check one: .Dec* 24 Date. Regisi irtuary Science Licensee) 1925— CEMETERY^OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body wa«_ J \ (State whether cremated, buried, stored, eteU * / * in (Ceipetery 6r crematory) . Signature (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B*26 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION No_ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 CLARA V, HERZEL _ Date of don th Dec ♦ 21,io 85 J <2^/^ 5/84 BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased Cause of d.sth Place of death LEWIS HERZEL______________________________ Date of dnath June 16,ifl 85 Congestive heart failure Barry Method of disposal _ rbbb white Hastings geT M AgB 86_ Woodland Memorial Park Burial (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION---------------------------- 1 (Cemetery or crematory) , . "------------------- ** . --------------- Date--------------------- 19-------- Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to Koops Funeral Chapel Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of body^f said deceased.^ Date Signature (Cheek one: ^P1 Re/fstrar. June 20, 19 25— f~~l Funeral d|rector^>O Mortuary Science Licensee) CEM^BRY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body won f 19 inr^^FTnA^jZusa ----------------------— (State whether cremated, buried, stored, etc.) (Cemgt^ry <njTrematory) Signaturetb**"*^^--F A (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). <0VB” ^3 �REMAINS TO DESTINATION r ACCOMPANY BURIAL—TRANSIT PERMIT THIS PERMIT ML ACCOMPANY REMAINS TO DESTINATION ’ THIS PERMIT M l MARJORIE OLETA McARTHUR___________________ Data nf death April 3Qq_85_ Full name of debased Respiratory failure__________________________________________ __ ________________ Cause Of dpsth Place of death____________ Barry___________________ Hastings________ (County) rBPb Spy F. White Age (Township or village or city) Method of disposal________________ Burial___________________________ Woodland Memorial Park_________ . (Whether burial, cremation, storage, etc.) 1 (Cemetery or crematory) —............... i Countv______ , Barry____________ stat* Michigan------1---------- ------------- 2--------------------------- : ------------- ------------ APPROVED FOR CREMATION Signature of Medical Examiner__________________________________________________ Date______________ 19--------A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to Koops Funeral Chapels,Inc* Lake Odessa, Michigan_______ Address (Funeral director or person acting/ as such) to dispose of body^T saiduiqg€ased. y .s Zy-<*—___________ Date_________ May 3,________ 19. 85— Signaturq'^X^ (Check ernes co r* CO No.__________________ -___ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Jp Funeral DI rector Regi/trar, CEMJ£TERy OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was______ 19 i . Mortuary Science Licensee) ____________________________________________________—________ c"*"’”' (State whether cremated, buried, stored^ etc.) Pla^ (Cemgtcrx*tS^crematory) ' f zO Signaturp^_________ Ji v (Sexton or person in charge). s This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). 10VER> BURIAL—TRANSIT PERMIT No._______________ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased Cause of death_______ Cardiac arrest________ Place of death Date of ^aze1_ C«_jtenney_____________________________ . . .................. Barry_______________ Hastings__________________ _____________ gPYFem, Aga 90 RnPfl white (Township or village or city) (County) Method of disposal____________ Feb*21, *9 85 Burial________________________ Woodland Memorial Park______ (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION (Cemetery or crematory) Barry.......... | County...-. State Michigan- Signature of Medical Examiner________ ._____ ____________________________________ Date______________19______ A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to. Koops Funeral Chapels, Inc, Lake Odessa, Michigan________ Add™** (Funeral director^xrjjerson acting as such) to dispose of bodynf s^id deceasddT^ Signature-—________ Date rCheck~one: Zj Registrar, £vj Funeral Director, Pa Mortuary Feb* 23, _____ 19.85 Science Licensee) CEMEIERfY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was(State whether cremated, buried, stored, ®tc.L^ in *Z 5~_________ /*> ________________ ___ (Cempterf or crematory) (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER)/J2, y SJ+- �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased Moms C* Car.ey---------------------------- --------- Date of death Feb. 21, 19 85 Cause of death Massive left hemisphere intracerebral hemorrhage Place of death Barry Method of disposal Hastings (Township (Countyfeurial or village or city) white Male"Age. Agff 80 Woodland Memorial Park (Whether burial, cremation, storage, etc.) (Cemetery or crematory) Barry ] CdOTty . APPROVED FOR CREMATION Signature of Medical Examiner --------- - stafa- .__________________________ Michigan 19. Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels> Inc. Address Lake Odessay Michigan (Funeral director or person acting as such) to dispose of body Signature, February 23. . Date 19-85. ortuary Science Licensee) (CReck one: OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW CEME' Body was. crematory) Signature^ (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased KATHRYN L. ___ Date of death_^.T-3J‘l-'Z—19— CLUM CARDIAC FAILURE Cause of death Place of death HASTINGS BARRY Race. (Township or village or city) (County) WOODLAND MEM, BUR I AL Method of disposal [.County PARK- MICH.----- Stnfp BARRX- , Signature of Medical Examiner. hereby given 22 (Cemetery or crematory) (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION WHITE Sex£E_ Age Date 19---- — A certificate of death having been filed as required by the laws or regulations of this state, permission is WREN FUNERAL HOME, INC. HASTINGS, MICH. (Funeral director or.person acting as such) to dispose of body of said decease^*. y /) ^ ) jfLrDate—FEB . Signature (Check one: O Registrar, O Funeral Director, 2--------------- 19 .S5. dt Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW _______________on Body was . (State whether cremated, burled, stored, eu.)x^7 J S V » -------------------- (Cemetery OTcrematory) iP Signature ' 1 in / (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) Zb A ---- �TH ISPERM IT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT no MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 MYRTLE M. RAIRIGH Date of death Mar t- .10 49 86 Full name of Cause of dee th Place of death Bastill8s BarrY Sex F . . Age 87 Race, W (Township or village or city) (County) Method of disposal Burial________________________________ Woodland Memorial Park APPROVED FOR CREMATION---------------------------- 1 • ** Wg Signature of Medical Examiner Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Address Koops Funeral Chapels,Inc, Lake Odessa, Michigan (Funeral director or person acting as such) s to dispose of body/pi said Date Signature- March 14, 19 86 4djeck~one:/Q Regpdrar,|"X Funera^ Dire^tf.Qfl Mortuary Science Licensee) CEM^T^RY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE^BELOW Body was Z< nn ?> - n (State whether cremated, buried, stored, etfrU^ / . in Z/9 ' (Cemetery orffiffiatory) Signature ‘ (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 (OVER) 5/84 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of t»rnrmr~* Cause of death No------------------------------------- MICHIGAN DEPARTMENT OF PUBLICHEALTH Act 368 of 1978 and Act 299 of 1980 APRON G- McC.T.F.TJ.AND--------------------------- Date of death IQ-fU-19-&4- " BRAIN TUMOR--------------------------------------------------- ------------ “ ■ —J.ARRI--------------- HA STTNGS TWP. Place of death — Rac<u_JUlXXE------ Sex_M-Age22_ (Coun‘.1')BITR tat. hl— lllw<>rclty> wnnni.ANn mem, park---------■ DUK.L Ab <T— — , .tel ( Cemetery or^ crematory) ------------------------------------------------------------------------------------------------------------------- stafn m ............................. Method of d1sposal APPROVED FOR CREMATION —---------------------- - ■ —----------------------- "------” Signature of Medical Examiner. Daly 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to WREN FUNERAL HOME Addr*** MT HASTINGS, _ (Funeral director or person acting as such) to dispose of body of said deceased* Signature (Check'one: ~ . ----------------------- Date 0(?T. Funeral Director. Registrar. Mortuary Science Licensee) 19—26. 10 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was.---------------—___________________ on________________ 19 jn_________________ ____________ .________ (Cemetery or crematory) (State whether cremated, buried, stored, etc.) Place-------------------- ---------------------------------------------------Signature________________________ ___ ________ ,__________ (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) Body wan THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION B-26 5/84 Full name of deceased Cause of death Place of death BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 CELESTIA MAE MCCLELLAND Date of death ’____________________ RESPIRATORY FAILURE Age 99- . RaceWHIIE__ Se£E HASTINGS TWP. BARRY 19 86 (Township or village or city) (County) Method of disposal BURIAL__________________________________ WOODLAND MEMORIAL PARK _______________ (Whether burial, cremation, storage, etc.) (Cemetery or crematory) BARRY I^County^^ APPROVED FOR CREMATION State MI Signature of Medical Examiner —-------— —19 Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn WREN FUNERAL HOME, INC, Add™* HASTINGS, MICHIGAN (Funeral director or person acting as such) to dispose of body of said deceased* / Date Signature (Cheek one: O Registrar, O Funeral Director. NOV* 15 1986 jty Mortuary Science Licensee)*i. CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW _______________ t\r\/! I 19^^ in _________________ i. v (State whether cremated, buried, stored, etcA-? 1 /• (Cemeterydffcrematory) . fSignature_ -rf ,<1 f.S----- z‘ r (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 (OVER) 'ZoJ' ' / 3) 2, �BURIAL—TRANSIT PERMIT Full name of deceased MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 OWEN M ■ HYNES______________________________ Date of death 7-23STROKE_______ Cause of death No 19-86 K Race___ WHTTR Place of death_______ BARRY__________________ HASTTWflfl TWP. Sex M—Age-gO (Township or village or city) (County) Method of disposal BURIAL WOODLAND MKM | County APPROVED FOR CREMATION PARK (Cemetery or crematory) (Whether burial, cremation, storage, etc.) BARRY . State—ML Signature of Medical Examiner Date — 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m NASHVILLE, MI VOGT CHAPEL-WREN FUNERAL HQME&a (Funeral director or person acting aa such) to dispose of body of said deceased. s / Date Signature. (Check one: Fundral Director, QHRegistrar, -JULY 24 19.86 Mortuary Science Licensee)' CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). «>vE«^7-y' B-26 5/84 BURIAL—TRANSIT PERMIT Full name of deceased Cause of death No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 ESSIE MAY LEHMAN Date nf death Jan 16 a- 19-86- Repeated extension of cerebral vascular accident Place of death Hastings Rare white Barry Method of disposal Sev F_ Age 93- Woodland Memorial Park Burial (Whether burial, cremation, storage, etc.) (Cemetery or crematory) APPROVED FOB CREMATION---------------------------- 1» SUU MiChijBB__ — Date Signature of Medical Examiner 19------- A certificate of death having been filed as required by the laws or regulations of this state, permission it hereby given tn Lake, Odessa, Michigan Addroaa Koops Funeral Chapel (Funeral director or person acting aa such) to dispose of body e^sajd deceased/n Signature 7 AZ(Check one: Rmstrar, Date. Funeral!Director; January 18, 1986— Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW xo - € Body was__________ ______________________ on / ~~~ Vwb in____________________________ _ — .(State whether cremated, burled, stored, etc.).- y/*^ ~ .-f~) » / (Cemetery ©/crematory) (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) ^^5. B-26 5/84 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 CARL JOHN GERLINGER _ Date of death Nov • 29 iq 86 Full name of deceased Irreversible cardiogenic shock cause Of death Place of death Barry _ w .. Aga68.. M Hastings Race White (Township or village or city) (County) • i n n Burial__________________________________ Woodland Memorial Park Method O£ disposal (Cemetery or crematory) (Whether burial, cremation, storage, etc.) —" 1 APPROVED FOR CREMATION ■■■—■ i 1 County------1 Barrv Michigan 8W* '■■■■ Signature of Medical Examiner, ~ Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels,Inc. Lake Odessa, Michigan Addrw (Funeral director or person acting as such) Date " Director, iq 86 December 2, X~l Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). Cz. (OVER) BURIAL—TRANSIT PERMIT 1 ’ Full name of deceased MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Baul E» Gould, Sr. Date of death Barry_______________________ Hastings Method of riiKposel Burial Rex M Rare White (Township or village or city) (County) 4*~3~ 19.66— ?. Cardiopulmonary Arrest Cause of death Place of death No _ ., , . .. Age 65 - Woodland Memorial Park (Whether burial, cremation, storage, etc.) APPROVED FOX CREMATION---------------------------- Rarrv (Cemetery or crematory) 1 Signature of Medical Examiner Date 19------- A certificate of death having been filed as required by the laws or regulations of this state, permission is Address—Mulliken, Michigan------ 48861------ hereby given to Barker-Leik Funeral Home (Funeral director or person acting as such) to dispose of body of/lid deceased../ /} / -- ------ - Date_A£ril-------- 7,--------- 19 86_ * (Check orfe: Q Registrar, Funeral Director, 09 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was (State whether cremated, buried, stored, etc. This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 ‘A-TZUr �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No----- MICHIGAN DEPARTMENT OF PUBLIC HEALTH ~ « AcOfiB of 1978 and Act 299 of 1980 „ .. . . , NORMAN G. COa n&te of deathFeh >- 3—19 86. Full name of deceased---------- -----------------------------—------- --------------------- -------cause of riesth Cardio Panary Arrest------------------------------------------------------------------------ — Place of death Barry Method Of disposal . Race_Whltg-------- Sex_£L_ Age21_ Hastings BuriaT°wn8hiP °r vi,,agc or c<ty) (County) (Whether burial, cremation, storage, e^arrv Woodland Memorial Park (Cemetery^r ^"^Jhigan ——------------------------------------------------- —------------- 1 County Parr2---------------- -------- State--------------5-------- — APPROVED FOR CREMATION > ----------------------- ---------------------------Signature of Medical Examiner.-------------------------------------------- -------------- - ---------------- Date-— 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is Gary J R. Koods vhereby v given . to ajj™935 4th Ave. Lake------------------Odessa, Mich -------- Address --------------------------------------------- (Funeral director or person acting as such) HOOH? to dispose of body o^saidrieceased.^.--^7^ Date Signature (Check one: ReE&rp4, O Funeral Dlr^tor, February 7------------ 19_86_ ^Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was - io4 4 in oa (State whether cremated, buried, stored, ^tc.) (Cemetery or/tTemhtory) (Sextonxjr person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 (OVER) 5/84 */ <£o-4 3.-41 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 ROSA E. VELTE___________________ Date of death Aug. 5 19,87 Acute Pulmonary Edema_____________________________________________________ Cause of death Place of death Barry____________________ Hastings Rflpe White Sex-?— Age. 91 (Towns)iip_or village or city) (County) Woodland Memorial Park Burial Method of disposal— (Cemetery or crematory) (Whether burial, cremation, storage, etc.) ~ APPROVED FOR CREMATION I -G?Un^----------------- — Signature of Medical Eraminer stat* , . Michigan Data 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn KooPs Funeral Chapels, Inc Address (Funeral director or person actins as such) to dispose of bod said decease 935 4th Ave, Lake Odessa, Mich 48849 1 Signature. 1987 August 7 Q"Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was \ ■'____________ { 19. (State whether cremated, buried, stored, etc.) iatory) *£- Signature. (Sexton, or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 (OVEB>^a7"; 5/84 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No------------------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 pf 1980 GERTRUDE B« ROWLADER _ _ Date of death May . 2Q19 87 Full name of deceased Congestive Heart Failure Cause of death Place of death * Barry___________________ Hastings (C°Unty> Method of di^ei Race White (Whether burial, cremation, storage. etcJ (Cemetery or crcrj^£^-[ gan State l £ APPROVED FOR CREMATION Age93 Sex_F Woodland Memorial Park ,l,worclty> -————— Date Signature of Medical Examiner —19-------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giv,nfn Koops Funeral Chapels, Inc. 935 4th Ave- Lake Odessa» MI (Funeral director or person acting as such) 48849 to dispose opbofiyvjf said deceased. . Signature X Date ft Registrar. (Cheek one: Body was Q rflineral^Mrector. Na.V 22, 19^7 Q^Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW nn)Y\^f 2* % 19^7 in -------------------------- ■» (State whether cremated, buried, stored, ’ ? C/J ’ ( (Cemeter^or crematory) (Sexton or person in charge) ’ This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). <0VE“’ BURIAL—TRANSIT PERMIT Full name of dpceosed No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 (FANNY) FANNIE ALMA EMTIH „, Congestive Heart Failure Cause of <w.h Place of death „ Date of death, ^.l-3 ; 19®L__ ' Hastings Method of dismal Raca Sex-L-AgeJ4 Vfoodland Memorial fork °r v,,,w " dty) (Cemetery or crematory). (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION---------------------- 1 Signature of Medical Examiner------------------------------------------------------------------ ----- Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m Koops Funeral Chapels, Inc.935 4th Ave. Lake Odessa, Michigan (Funeral director or person acting as auch) to dispose of body of said deceased. 4 48849 f n.u Signature. * (Check rector, February 6 i9£ Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. in. .on. iterx or crematory) Plat ' (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). M 5/M �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased Cause of deeth Place of death MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 INEZ-P,±-?9VERS---------------------------------------------- Date of death May 24, is 88 Cardio-pulmonary arrest ____ ________________ _ Rare white — Albany, Georgia Sylvester- Sex E_ Age ®Z_ (Towqship or village or city) (County) Burial_____________________________Woodland Memorial Park Method of disposal (Cemetery or crematory) (Whether burial, cremation, storage, etc.) ", ~ I County -Barry 1 APPROVED FOR CREMATION I Signature of Medical Examiner. . ... — y . ■■■ state ° J ----- ---------- Michigan Date , 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given t0 Koops Funeral Chapel Address Lake Odessa, Michigan (Funeral director'or person acting aa such) to dispose of body, of said deceasjed^^^ s —-________ Date_______ May 28,_______ 19 88 Signature Regiyfrar, (CUeclT^ner Funeral Director, y Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). >*26 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION No. 5/84 BURIAL—TRANSIT PERMIT Full name of deceased Cause of death Nov* 3,ig 87 Respiratory arrest _ Hastin«s Barry Place of death No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 LORRAINE H. ROGERS Date of death white Spy F Age 70 (Township or village or city) (County) Burial Method of disposal Rare : Woodland Memorial Park (Cemetery or crematory) (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION---------------------------- 1 Signature of Medical Examiner - ■ __________________________________ Date ;___ 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to Koops Funeral Chapels, Inc* Address Lake 0d4ssa, Michigan L (Funeral director or person acting as such) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW & % 19^7 in Body woe (State whether cremated, buried, stored, etc.Lz3 / . _ (Cemptery5srcrematory) g--*_______ , / (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). .w 10V™^ob �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Full name of deceased Cause of death Respiratory Arrest „____________________ Barry Place of death Method of disposal Woodland Memorial Park ’ Burial Barrj^. ...... . . stato TTichigan, Signature of Medical Examiner Date ’19 A certificate of death having been filed as required by the laws or regulations of this state, permission is to Koops Funeral Chapels, Inc. 935 4th Ave. Lake Odessa, MI (Funeral director or person acting as such) to dispose of body of s^id-deceased. _____ Signature Agp 4 gpy F White Woodland APPROVED FOR CREMATION-----------------------------| County....— hereby given . No. BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 PAULA JEAN MUSBACH______________________ Date of death Dec • 23 iq 87 (Check one: ; 48849 December 26, sO , Reglstrar,0 □ Funeral Doctor, 1Q87 ^Mortuary Science Licensee) -------------- CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was— \ (State whether cremated, buried, stored, etj (CemetmTbr crematory) Pll ■— Signature . .. / (Sexton or person in charge) This permit must be endorsed by the sexton Cor by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 ’ noon? j (OVER) (FMjT �BURIAL—TRANSIT PERMIT Full name of rtorenaed Cause Of death No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 GLADYS L. CROCKFORD Dateof dpath Feb, 26 19_87__ Cardio Pulmonary Arrest Place Of death Bbpb Barry___________________ Hastings Method of disposal t r* t Woodland Memorial Park (Whether burial, cremation, storage, etc.)_ — Agp 89 . Burial 1 q„Y F White (Township or village or city) (County) (Cemetery or crematpryJ , . i rnnntv Ionia gt,** Michigan —^County——-5 ----------- *1 APPROVED FOR CREMATION Signature of Medical Examiner Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn KooPs Funeral Chapels, Inc. Addr^ 935 Ath Ave- Lake Odessa, Mich. (Funeral director or person acting as such) 48849 to dispose of body of said deceased. Signature-■ Uw/ Z. n^Jebruary 28, 19 87 (CheclTon?': Tfc)' Registrar, |£j Funer^Director, Q^Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW eg This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (over)'7'^R/PriTr " fidd-iTioH 4 B*26 5/84 BURIAL—TRANSIT PERMIT No. Full name of deceased MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 SAMUEL S« FETTERMAN _ Date of death Nov* 27 ^87 Cause of death Acute Myocardial Infarction _J Barry___________________ Hastings Place of death Method Of disposal White gPY M Agft 75 p^p or viUage or city) (Whether burial, cremation, storage, etc.) ■■ ■ ■ ■ ■■■■■ APPROVED FOR CREMATION • i — (Cemetery or crematory) Barry 1 County----- * Signature of Medical Examiner------ ----------------------------------l; , Michigan State.............. 6------Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels, Inc* Addreww 935 4th Ave* Lake Odessa, Mich W (Funeral director or person acting as such) to dispose of body of-said deceased. i Signature_______ S* (Check one Body was. . k / lor, ___________________ nah November 30 w 87 Q*$dortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW _______________nn K, 36 i9_£jL ______________ (State whether cremated, buried, stored, etc.) (£) . (CMneterjMJr crematory) I Signature/y l (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 < ' . �th is permit must accompany rem ains to destination BURIAL—TRANSIT PERMIT Respiratory Arrest Place of death iS88 __________________________________ Woodland. Rape Barry Age 72 (Cemetery or crematory) . (Whether burial, cremation, storage, etc.) ----------------- —------------------------------------------------ 1 County APPROVED FOR CREMATION L— Signature of Medical Examiner Se, F White Woodland Memorial Park Burial Method of disposal Barry ■■ TTidhigan ■ ■■ _———.—-____________________ Date 119 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m Koops Funeral Chapels, Inc. Aridrp„ 935 4th Avenue Lake Odessa, MJ (Funeral director or person acting aa such) to dispose of 48849 said deceased. __________________ tw* Signature^ ^^^7] (Check one: lor, gistrai 19-88 August 10 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was ____________ on State whether cremated, burled, stored, $tc.) in. t (Cejpetery or crematory) (Sexton or person In charge) ' This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) »-26 THIS permit must accompany rem ains to destination MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 KATHRYN E. POTTER---------------------- ---------------- Dateof dwth Aug. 7 Full name of deceased cause of No 5/84 BURIAL—TRANSIT PERMIT Full name of deceased Cause nf death . Pneumonia Place of death No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 „ STELLA SMITH ____________ Date of death Sept. 9 ng 88 , ___ Hastings Barry Burial Method of disposal ger Rape white P Age Woodland Memorial Park (Whether burial, cremation, storage, etc.) Barry (Cemetery or cremato^^ I County----- APPROVED FOR CREMATION Stot<> Signature of Medical Examiner Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to ..Koops Funaral Chapel - ' Address Lake Odessa> Michigan (Funeral director or person acting as such) to dispose of bodv%f sjrfd deceased. , Signature Date _ XCheSFone: nXZglstrar, fJQ Funeral D (Zee tor, September 12, iq 88. Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was---< (State whether cremated, buried, sto^pd, etc/CP 7/ (Q . (Cemetery or crematory) Sig ' (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). <0VE"> �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Full name of deceased BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 MARY Ao OSTROTH Date of death _ 5~31“* 19 88 Cause of death CARDIO RESPIRATORY ARREST Place of death HASTINGS Rare WHITE BARRY Agp 73 WOODLAND MEMORIAL PARK BURIAL Method of disposal SpyFE (Township or village or city) (County) (Cemetery or crematory) (Whether burial, cremation, storage, etc.) [ County APPROVED FOR CREMATION State BARRY Signature of Medical Examiner MICH Date 19 A certificate of death having been filed as required by the laws or regulations of . this state, permission is hereby given M ™ FUNERAL HOME HASTINGS, MICH Addresa (Funeral director or oft-son acting as such) / to dispose of body of said deceased/*” 2/ ' Date Signature Registrar, (Check one: Body was, . CZr Funeral Director, JUNE 1___________ 19 88 njMortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW 19 o$ in (State whether cremated, buried, stored, etc.)-^ zx? . I k (Cemetery or crematory) Signature (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION I 1-26 5/84 Full name of deceased. Cause of death ■ Place of death BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH GERAL^^WdAc'299 0(1980 Date of death Aug. 6 Myocardial Failure . Barry Hastings Burial Method of disposal _ Rbpb APPROVED FOR CREMATION I cmmty y Agg 77 Woodland Memorial Park (Cemetery or crematory) . (Whether burial, cremation, storage, ctc.)n ---------------------------------------------------------- 1 __ White' <.PY M 19 88 stat* Michigan Barry Data Signature of Medical Examiner 19 A certificate of death having been filed as required by the laws or regulations of* this state, permission is hereby given tn Koops Funeral Chapels, Inc. (Funeral director or person acting as such) AHdr.., 935 4th Ave. Lake Odessa, Mich. 48849 Data August IQ,19 88 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Full name of deceased BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH » ..... Act 368 of 1978 and Act 299 of 1980 LGNG_____________________________________ Date of death Nov‘ . Cardio pulmonary arrest Cause of death Barry.Hastings RnM> Place of death Method of disposal White Agg 69 M woodland Memorial Park ounal (Whether burial, cremation, storage, etc.) D »"W APPROVED FOX CREMATION---------------------------- 1 (Cemetery or crematory) . W BlchlSa" ■ Signature of Medical Examiner Bate 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops Funeral Chapels, Inc, hereby given te Lake Odessa, Michigan Address (Funeral director or person acting as such) to dispose of body ofsaid deceased^'—X . / November 12, Signature (Check one: O Registrar, iq 88 Jp Funeral Di/ector,ffl Mortuary Science Licensee) CEMETEI& OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was.____ _________________________ > nn/ffixZr j I (State whether cremated, buried, stos^d, etc.L^ / ________________ in /# v /} (Cemetery of*crematory) , Signature-2^i21±21<=tZS^=^=g»e (Sexton or person in charge) / This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) (3^ (a <■*-> ►-26 5/84 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION 88 BURIAL—TRANSIT PERMIT Full name of deceased Cause of death MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 LLOYD L,. MAKLEY Date of death Oct. 26,88 Cardiac arrest —— t _ . white BarrY_____________________ Hastings Place of death Method Of di.noM.l No -<*<■*■ M Age 8— Woodland Memorial Park <County) Burial (Cemetery or crematory) (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION---------------------------- 1 County —Barry . state Michigan . Date Signature of Medical Examiner 19. — » A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels.Inc, . ./(Funeral director or person acting as such) Lake Odessa, Michigan Address Address. to dispose of bodyZox aid decease October 29, Signature. 19 88 Mortuary Science Licensee) CEME'rfgRY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. Plal in. .0119j (Cemetery•orc rema tory) Signature. ' (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B*26 (OVER) 5/M �BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 EVERETT W, JOHNSTON D«t<> of rfpath Aug 18, Full name of Horpocpd Respiratory arrest Cause of death Place of death ________________ Hastings Ra„fl white Barry Aga 69 M (Township or village or city) (County) Method of disposal 88 Woodland Memorial Park purl.al (Whether burial, cremation, storage, etcJ APPROVED FOR CREMATION i rnnntv [^uounry ■■■ "‘""2 ". (Cemetery or crematory) a*-** Mate Barry - Signature of Medical Examiner Michigan Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m S 8 Koops Funeral Chapels,Inc. Lake Odessa, Michigan Addrpsa (Funeral directoror person acting as such) to dispose of bodx^of^aid decease#/ o _______ n-t* -1 Signature (Check one: CO p S Q Registrar, O Funeral Dilator, August 70, 19 88 Q Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was _ j \ (State whether cremated, PladA2eg^Z^-7PT^/ sj f burled, stored, etc.P^^ (j'**-*C (Cemetery or crematory) , (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). ,over) BURIAL—TRANSIT PERMIT Full name of dpreaapd Cause of death Place of death No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 HENRY FORD LANDIS Date of death May 21, 1988— Cardiac arrest________________________________________ Barry Hastings Ra<*a White Burial Method of disposal .^v M Age 71 Woodland Memorial Park (Whether burial, cremation, storage, etc.)_ APPROVED FOR CREMATION--------------------- __________________ (Cemetery or crematory) . . 1 Signature of Medical Examiner Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to Add™** Koops Funeral Chapels Lake Odessa, Michigan CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics JAMES P. TYLER Date of death Nov. 24 f 1989 Full name of deceased Cause of death Place of death Congestive heart failure Barry ___ Hastings Rare white Burial Method of disposal (Cemetery or crematory) (Whether burial, cremation, storage, etc.) ~l County _Barry_ APPROVED FOR CREMATION -------- State,Michigan.^. 19— Signature of Medical Examiner' Date to A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver Koops Funeral Chapel__________________ Address Lake Odessa, Michigan Mineral director or person acting as such) to dispose of bodp'opSaid deceased^ . Signature Date_ **4Check one: Refistrar. X) Funeral Director. Nov. 27, 19S2_ QQ h^ftuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW on J7 19.81 in - IState whether cremated, buried, stored, etc.) I /vz'V ^Cemetery or crematory) Place—___ ZoTL. .....xS________________ Signature__ ..Zz/iJr__ L__ ------------------------------ Body was, (Sexton or person tn charge) * This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton), (OVER) B-M 4/M Authority: Act 368 of 1978 and Act 299 of 1980 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION SexK_ Age 54 Woodland Memorial Park Full name of deceased Cause of death BURIAL—TRANSIT PERMIT No._---MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics MAUDE A. YERTY-------------- Date of death 2---------------19----j CONGESTIVE HEART FAILURE _ ________________ RaCe WHITE. Sex 2L AgeZ£_ WOODLAND MEMORIAL PARK Place of death BARRY HASTINGS _________________ ,Co*",,rt nmT4r. fr*“WPW’lnM'*d,rt Method of disposal---------------------- (Whe<h« buriJ*remuion. now. etc.) (Cemetery or crematory) t ------------------------------------------------------------------------ “1 County BARRY State —--------------APPROVED FOR CREMATION J . ■■■ ■ Signature of Medical Examiner—:.—-------------------------------------------------D*1® -- ------------------------------ tQ A certificate of death having been filed as required by the laws of regulations of this statepermission is hereby given WREN FUNERAL HOME ___ Addr^s HASTINGS, MI (Funeral director or person acting as such) / to dispose of body of said depeasptf. Signature Date (Check one: Registrar. DEC. 20 19-82. f~l Funeral Director. Jpf Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Bodv was —________________ on GjBK19 #2. jn (J ^^State whether cremated, buried, stored, etc.) 1 Place—lS-—2J___________________________ h ZmL (Cemetery or crematory) Signature__ r '(Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). B-M 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Myocardial Infarction Place of death _ ■ Barry Method of disposal Rare Hastings W gPT F Agp 76 Woodland Memorial Park Burial (Cemetery or crematory) (Whether burial, cremation, storage, Barry------------------ APPROVED FOR CREMATION---------------------------- 1 County Signature of Medical Examiner State Michigan 19 Data _ A certificate of death having been filed as required by the laws or regulations of this state, permission h hereby given tn Koops Funeral Chapels Lake Odessa, Michigan Address (Funeral director or person acting as such) to dispose of body of^id deceased.^ Dnfa Signature (Check one: CD ReprfCtrar, Funeral director, June 7, 19_89 nfifortuary Science Licensee) CEMjyERYjOR CREMATORY AUTHORITY SHALL FILL OUT SPACg BJ^LOw" fon._________ 19j££_ in Body was. c: (State whether cremated, buried, stored, etc.) (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). I«26 TH IS PERMIT MUST ACCOMPANY REM AINS TO DESTINATION, MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 RACHEL AGNES HAGER _________ Date of death June 5, 1<>89 Full name of dereasted Cause of death No. 5/84 BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 ROBERT LYLE HAZEL___________________ Date of death Au8’ 19 19 89_ Full name of deceased cause of death _ ___________________ Pneumonia Barry___________________ Hastings rbph White s„Y M tCounty> Burial "vlllw or Woodland Memorial Park Place of death Method of dt-p^i (Whether burial, cremation, storage, etc.) ■■■■■■■—■ No ■ APPROVED FOR CREMATION ■■■ i n (Cemetery or crematory). Barry -------- / (Um.hr | County Signature of Medical Examiner Stat* Age 66__ , Michigan n ■— .____________ Date^ 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels, Inc« A<Wre«* (Funeral director or person acting as such) to dispose of body aid deceased. ZT"____________________ Signature. (Check one: Body was 935 4th Ave, Lake Odessa, Mich 48849 Regie r>»tP August 22 1989 irtuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW. 19-8X- fa ------------------------ on_ (Statewhether cremated, buried, stgred,*tc.) fodc (Cemetery or crematory) Place—P /o T~—2----------- ----------------------------------- Signature (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 (OVER) 5/84 �Full name of deceased Cause of 01—09 1989 ________________ . CARDTAG ARREST death Place of d.nth Method Of No. HASTINGS TWP. Rp„fl WHITE Spy M (to-M,,r»D MEMORIAL PARK HARRY BURlA^ (Whether burial, cremation, storage, etc.) ------------ - -------------------------------------------------------------- 1 Honntv APPROVED FOR CREMATION 1 C°unty Signature of Medical Examiner — . Age_93 (Cemetery or crematory) _ MICH BARRY - ------- S^te— IUWU-- , _____________________________________________ Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given te VOGT CHAPEL/WREN F^H. MICHIGAN a ddreasN ASHVILLE, (Funeral director or person acting as such) . to dispose of body of said deceased. r /Check one: Q Registrar, O Funeral Director, /d,__________ 19/3* 7 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW —L3 19_^£ Body was . (State whether cremated, buried, stored, jtc.) (CemeteryTSrcrematory) Signature^ (Sexton or person in charge) / This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). <0VER) 0^-5“ ’ THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 CHARLES FURLONG __________ Date of death THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAl^-TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death JAMES C* GARDNER___________________________ j CARDIAC ARREST BARRY Place of death Date of death 3*1„6~82—19----’ •' WOODLAND MEMORIAL PARK BURIAL Method of disposal (Whether burial, cremation, storage, etc.) (Cemetery or crematory) _ _________________________________________ 1 County BARRY APPROVED FOR CREMATION ■ ■—■■■ ■ Signature of Medical Examiner to Sex -M . Age -64 Race WHITE WOODLAND TWP, (Township or village or city) (County) — ■? State MICH _ _______________________________________ Date----------------------- 19------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given WREN FUNERAL HOME ' Address HASTINGS. MI________________ (Funeral director or person acting as such) to dispose of body of said deceased. ,, X*' / Date MAR, 23 Signature (Check one: Body was O'Registrar, Q Funeral Director. 19 89 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACEBELOW p. J___________ _ on Vfi o? V !9fcfL in Place/J ffosrMKj n {) — Signature (Sexton or person in charge)- \ This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER)^ . B-26 4/M Authority: Act 361 of 1971 and Act 299 of 1980 , . n . . . - �BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 ETHLYN C. BURKLE Date of death Full name of deceased__ 89 Sept 6 Cerebral Casculr- Insufficency Cause of death_________ Hastings Barry Place of death__________ . Race. (Township or village or city) 1 Buri (County) White Ap’p Spy 95 Woodland Memorial Park Method of disposal______ (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION 1 County Signature of Medical Examiner „ (Cemetery or crematory) . Michigan -1------ ------------- Sti ,......... ____________________________________ Data 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels| Inc, Addr<»RR 935 4th Ave. Lake Odessa, Mid (Funeral director or person acting as such) 48849 to dispose of body of saicLdeceased. September 8, Signature (Check one: Rdgis r. /fe 19-82 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW . ___________________ »n in ( J MaOT/fr/Wfa/ fafc Body (State whether cremated, buried, stored, etc.) I Place£l£i3_LtfXs3_______ ____ ______________ Signature-^2 (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Full name of deceased________ JENNIE DUITS_____________________________ Date of dnath June 1619 89 Cause of death______________ ___________________________________ Place of death_______ Barry_______________ Hastings__________________ white (Township or village or city) (County) SpY F . - _ Age 80_ i Method Of disposal______________Burial_________________ __ ___________ Woodland Memorial Park_______ (Whether burial, cremation, storage, etc.) _ (Cemetery or crematory) , ' APPROVED FOR CREMATION--------------------- 1 Signature of Medical Examiner ___ —----- — »*' Date-------------------- 19--------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to_______ Koops Funeral Chapels, Inc* Addr^R S o u o Lake Odessa. Michigan____________ (Funeral director or person acting as such) to dispose of bodv/ofsaid deceased^ < —----------------- Date-------- June 19,------------ 19 §9_ (Vheck one: THIS PERMIT M l W J^fistrar, O Funeral^Jlrcetor^L) Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE,BELOW Body wag^"ft<O) g __________ nn J 19_&2_- in----- C? • (State whether cremated, buried, stored, etc.) * IjJ fYii/WU QL j -------------- (Cemetery or ^remat^ry) ft mJ) ----------- — ] (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). „„ B-26 5/84 <?i <OT“> �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BUR1AL—1KANSIT PERMIT Cecil C. Bennett Date of death April 6* 19-90 Full name of deceased Cause of death cardiac dysrhythmia___________________________________ Place of death Hastings_________ Race, white Barry -—Upodland Memorial Park Burial Method of disposal (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION------------------------------ 1 (Cemetery or crematory) CMM, ^8.. Signature of Medical Examiner to Age26L_ SexM (Township or village or city) (County) _________ 19 Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given Koops Funeral Chapels Address Lake Odessa, Michigan (Funeral director or person acting as such) S to dispose of bod#of said deceased. Date April 9; ? Signature one: F^dtegistrar. 19_90 Mortuary Science Licensee) Funeral DircctfK. CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was------ . . ? on _ (State whether cremated, buried, stored, etc.) Place—-7____ Z-T 19 in l*>o***-&*—«' 1 i ____________ Signnh.m 7^/ (Cemetery or crematory) (Sexton or person in charge) ' This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/M Authority: Act 368 of 1978 and Act 299 of 1980 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full ng,me of deceased Cause of death BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics LAWRENCE LEVI CHASE Date of death May 19, Renal Failure Place of death Barry _ ___________ ;__________________ Method of disposal SexJL Age®l_ Rarf white Woodland (Township or village or city) (County) Burial Woodland Memorial Park---------------(Cemetery or crematory) (Whether burial! cremation, storage, etc.) ] County State Michigan Barry APPROVED FOR CREMATION Signature of Medical Examiner— tn 19___ Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given Koops Funeral Chapels Address Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of body oLsaid deceased. ✓ Signaturfe,^ lewEk one: ^pJXeaistrar. Funeral Dir^lor. Date May 22, 19_90 j£] Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was 19 ------ on (Cemetery or crematory) etc.) Place—Klrt"—(a------ —/L/X______________________ Signature— ___ (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/M Authority: Act 368 of 1971 tad Act 299 of 1980 i �No. THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased Cause of death MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics VICTOR MELVIN WARNER Date of death —?~28~ iaJLCARDIAC ARREST_______________________________________________ Place of death HASTINGS TWP. BARRY Method of disposal Rare PARK------------- (Cemetery or crematory) | County APPROVFn rnw CREMATtQN Sex JL Age_ZJ WHITE WOODLAND MFM- BURIAL (Whether burial, cremation, storage, etc.) ------- State BARRY Signature of Medical Examiner MT, 19.----- Date. A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver to— WREN FUNERAL HOME Addies HASTINGS, MI Date 28, (Funeral director or person acting as such) to dispose of body of said deceased, Signature. (Check one: O Registrar. Z> y Funeral Director, FEB, 19 1991 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW ------------------ on 19 in ■ ■ Lf) Body was ____ Led.___ $____ Signature XffZdka---------------------' CI (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Sciendeltttfisee where there is no sexton), Place/Xo'T (OVER) B-26 4/88 Authority: Act 368 of 1971 and Act 299 of 1990 BURIAL—TRANSIT PERMIT THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION —---------------- Full name nfd^^ Cause of death No------- ---------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics DOROTHY RUTH WISE---------------------------------------- Date of death D.gC. 23^_ lft2L Cardiac arrest------------------------------------- --------------------------------------------------- -- Ptaeenfd.a.H Barry ...................................................... Method of disposal------------------- ~ Woodland Twp._______ Race whitg------- Sex-E- Age .§5 (Town.hip.r.ui.^.ra.rt Woodland Memorial park------------------.w^7^. CTOTMi... --------- I------------------- ---------------------------------------------------------- 1 Barry County 1 APPROVED FOR CREMATION Signature of Medical Examiner------- ——- ---------------- — State Michigan--------- - Date . - - - 19 ■ -- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver tn Address—Lake Odessa, Michigan---------------- Koops Funeral Chapel (Funeral director or person acting as such) to dispose of bc^fy op said deceased. Z Signature (Check onpf^D^fcgistrar. flQ Funjral Doctor. r—-:----------- : DMA ualc------------ Dec. 27. Mortuary Science Licensee) ■ 19-S1 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW _______ «, *z ■>.« , (Staif whether cremated, buried, stored, etc.) n - / . v . Place /CuC fj"~------- Sl8nature------^^e x ton^or^rsoniTch arge) This p^nitSikt ^endorsed by the sexton (or *y thefuneral director or Mortuary Sciencelice^see where there is no sexton). B-26 4/U Authority: Act 368 of 1971 and Act 299 of 1980 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Full name of deceased BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics ARLIE B. SLOCUM pate of death Acute Heart Failure Cause of death (County) , Hastings________ Method of disposal Burial F ^ge 9* - Woodland Memorial Park _ (Whether burial, cremation, storage, etc.) |County approved for cremation gex White (Township or village or city) (Cemetery or crematory) Barry -- ■ ■■ Michigan— state Signature of Medical Examiner - Date 19 tn A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei Koops Funeral Chapels, Inc, Address 935 4th Ave, Lake Odessa, MI (Funeral director or person acting as such) to dispose 48849 ody\)f said dec 1911 April 9, nate Signature fetor.Q Mortuary Science Licensee) (Check on CEMETERY ATORY AUTHORITY SHALL FILL OUT SPACEJBELO Body was on (Sexton or person tn charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION ________________________________________ Barry_______________ Place of death April 6 jq91 Full name of deceased Cause of death Place of death BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics CLARENCE C, REEVES Date of death Hastings Race Shite Burial_______________________ Method of disposal I Cnnntv ^county SexM— AgeZ3_ Woodland Memorial Park------------------(Cemetery or crematory) (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION —8»—19—91 ______________________ __________ Pnemonia___________________________ Barry - Barrv , State Mi chi gan----............ ■ _ Signature of Medical Examiner—. Date---------------------- 19— A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei Koops Funeral Chapels, Inc, Address Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of bod^opsaid dpoeasak s Signature ___ Date •^(Check^dfie: Body was (^/rfegistrar. ' (~X Funeral Dire<|»yC March 11, 1991- O Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW on // 19 4}/ in (State whether cremated, buried.stored .etc.) . V ■ *■ -. A (panetery or crematory) This permit must be endorsed by the sexton (orfyrhe funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 �BURIAL—TRANSIT PERMIT No._------ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name Of rinsed Cause of doMh P. MABEL Date of death DZ=15------ 1951 FURWNG CONGESTIVE HEART FAILURE -________ Race WHITE--------- Sex _EE- Age _83 BARRY Place of death (Township or village or city) (County) ------------ —WOODLAND MFMORI AT, gARK Method of disposal---------- BURIAL ------------------ (Whether burial, cremation, storage, etc.) ----------- -----------------------------------------------------------------1 r«„ntv APPROVED FOR CREMATION | county Signature of Medical Examiner State .MICHIGAN, ... ---------------------------------Date --------------------- 19— / A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby give to-MAPLE VALLEY CHAPET^ENTHER FIL HO, Address. NASHVILLE^, MT. (Funeral director or person acting as such) to dispose of bp^y of said deceased. t Signature (Check-one: BodV was Q Registrar, Funeral Director, i<lZ J*LMt>nuary Science Licensee) CEMETERY OR CREMATOR5LAUTHORITY SHALL FILL OUT SPACE BELOW Z~yyyKAJtfz/ nn 1 7 in ro^YburM. stored, etc.) CT el ' L ' ( Ca CTcniatory) Placed A-f <y g/y---- ^s^penonin charge)” ----------------------------------------------------------------------------------------------------------------------------- This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). B-M VII Authority: Act 3M of 1971 and Act 299 of 1980 (OVER) THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No------------------------- — MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics GRACE HILDRED HESTERLY Full name of deceased______________________ _______________________________ u n^nfri^th Sept 2 819 91 cause of death Method of disposal r Pneumonia-------------------------------------------------------------- -------- — Barry Hastings Twp Rac, White_ Sex_F_ Age88_ ic«.My> Burial <TownMUpor.iii.seor«,) woodland Memorial Park -- ...(Whether buna), ■■ cremation, storage, etc.). iftmticrv or crematory) (Cemetery or crcmaioryi o aw... aA n 1 County State--------------- 2-----APPROVED FOR CREMATION 1 -----Signature of Medical Examiner----------- ----------------------------------------------------- ---------------- Date--------------------- 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given lo Koops Funeral Chapelst Inc. AddwKRP35 4th Ave. Lake Odessa, M (Funeral director or person acting as such) 48849 to dispose o f said dec< Signature. Registrar, Body was - r>Am October 1 19-L1 Mortuary Science Licensee) EMETERV OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW on I9 _iL in , (Stale whether cremated. buried, stored, etc.) .cmetery or crematory) (7 . (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Sciencelicensee where there is no sexton). B-26 4/M Authority: Act 368 of 1971 and Act 299 of 1980 (OVER) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BU <1AJL—1 KAN 511 PERMIT SALLY J • HALE Date of death April 8 19 92 Full name of deceased Gunshot Wound to Head_____________________________________________________ Cause of death Place of death Woodland Twp Barry Method of disposal .. , ,- . .. - — . Woodland Memorial Park Burial (Cemetery or crematory) (Whether burial, cremation, storage, etc.) I rm.ntv I uouruy APPROVED FOR CREMATION Sex_£_ Age-16 Race White (Township or village or city) (County) M Barry state , Michigan *----- oiaie Date 19----- Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver Koops Funeral Chapels, Inc, Address to Lake Odessa 935 Fourth Ave, (Funeral director or person actin&as such) , MI 48849 to dispose of bodyirf said dece^ed.jz, Date April 11, Signature, > (Check 1992 Mortuary Science Licensee) CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW EMETERY Body wai Placed f (SextQfror person in charge) This permit must be endorsed by thd’Sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-M 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics Full name of deceased Cause of death BURIAL^-TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics JOSEPH A, VROMAN, JR, Date of death March 21 |q92 Cardiac Arrest________________________________________________________________ Barry Place of death Race Hastings (Township or village or city) (County) Method of disposal . Spy M , Age^L . Woodland Memorial Park Burial (Cemetery or crematory) (Whether burial, cremation, storage, etc.) I C° "ty APPROVED FOR CREMATION White Barry^ ------ State Michigan^ Date 19 Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby giver to—Koops Funeral Chapels, Inc, Address (runerai director or person acting as such) to dispose ofbodpof said deceaj£d. Signature jz? X (Check oncy (^Registrar, [jlFupxyal Dirccj^-. 935 4th Ave, Lake Odessa, Mich 48849 ________________________ Date I Mortuary Science Licensee) March 24. 19-22 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was------ —---------------------------------- on 19------ in Ol A. sWW c/cwted. bu««d, stored. etcx> (Cemetery or crematory) PlacefeMJ (lij__ fJWJlJ'tt <£>____________ Signature______________________________________________ / r (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Full name of deceased BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics RUSSELL D < BOOHER Date of death March 22^92 Congestive Heart Failure Cause of death Barry Place of death Vermontville Burial Method of disposal Race White Sex2L_ Age_§5 woodland Memorial Park APPROVED FOR CREMATION------------------------------ I Date 19— Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby givei Address 935 4th Ave. Lake Odessa, Mich 48849 m Koops Funeral Chapels, Inc. (Funeral director or person acting as such) to dispose o^bedy. of said decysed* March 25, Date Signature 19-92 Mortuary Science Licensee) £EMETERy4$R CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was----- on(Sexton or person in charge) '* This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Science licensee where there is no sexton). (OVER) I B>26 4/88 Authority: Act 368 of 1978 and Act 299 of 1980 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No------------------------------ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Office of the State Registrar and Center for Health Statistics KENDAL S. CURTIS--------------------- -------------------- Date of death Full name Cause of death . —i Small cell lung cancer--------------------------------- -------------- —— ° Barrv eat icoumy) Method of disposal w c ------- x_ia_ - - Woodland Race Wpnd Whiti eAnd ------ Memorial Sex------ Age ----------, rrowDEhip or villa,««cuy, Park '^”^^ichlgarT 1 approved for cremation Signature of Medical Examiner. Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given Koops Funeral Chapel m to dispose of bo Address hake Odessa, Michigan---------------- Funeral director or person acting as suetj) Signature^ March 2, Date 19-22 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was Place, on G* I Signature v , ictery or crematory) --------- (Sexton or person in charge) This permit must be endorsed by the sexton (or by thefuneral director or Mortuary Scienc'e licensee where there is no sexton). B-26 4/88 Authority: Act 368 of 1978 ud Act 299 of 1980 (OVER) �iviivtiiumi v \yr uihil .....................-J IF k DEPARTMENT OF PUBLIC HEALTH 3 CF................... ..1 state” file” number CERTIFICATE OF DEATH 0921708 /'DECEDENT NAME first RAQE • W f. WMt. Stock. AflMKa* Inman ale I (Specify) WHITE 4 MOS /YrsJ ___ DAYS I HOURS _______ |~xl "»*01 VILLAGE LIMITS OF >h oirf USA • NOV, ____________ WOODLAND ■ MICHIGAN ___ » USUAL OCCUPATION RES: FATHER-NAME ____________ 1_ BARRY 15b IT NO (Give kind o! work dong during most of working life. even if retired) LOCALITY iNS>0( CITY LIMITS Of (Check one 5 and specify) [_ inside village limits KIND OF BUSINESS OR INDUSTRY 19 PART I CAUSE STATING the UNDERLYING CAUSE IASI or WOODLAND 190 AMASA ST I5d MOTHER-MAIDEN NAME LAST WILLIAMS N DONALD N, WILLIAMS 118b FIRST MiODl( BETTY 17 MAILING ADDRESS INFORMANT \u/Signature) ^3.. GENERAL BUILDING 1 STREET AND NUMBER 15c. MlDOlt FIRST ihrw WAS DECEOENI IVER «N US ARMIO FORCES* ■Sprt <*r V* N*» (It wife, give maiden name) 14b. COUNTY DONALD IB BARRY tif uti "i fiiitn 190 AMASA ST. n 385-72-1910 I Sr. immediate 1960 23, SURVIVING SPOUSE NEVER io. U.S.A, SOCIAL SECURITY NUMBER MICHIGAN IF ANY WHICH GAVE RISC TO I MARRIED NEVER MARRIED. WIDOWED. DIVORCED iSpWttl CITIZEN OF WHAT COUNTRY SiRUT or R f O NO 325 MAPLE ST, SAWDY CITY ON I OWN ZIP STATE 49073 NASHVILLE, MI /ENTER ONLY ONE CAUSE PER LINE FOR /a), fb). ANO MJ IMMEDIATE CAUSE 1986 COUNTY OF DEATH MINS 7b_____________________ LJ STATE OF RiR Th (Mo. Day. Yr.) 3 MAY 27, (Mo.. Day. Yr.) (HOSPITAL OR OTHER INSTITUTION • N.m. ~z; CURRENT RESIDENCE STATE conditions | OATS OF DEATH ? MALE DATE OF BIRTH j INSIDE Cllv LIMITS or (Check one and specify) IF DEATH OCCURRED IN INSTITUTION. SEE MANUAL REGARDING COMPLETION OF RESIDENCE ITEMS UNDER 1 DAY | 6b LOCAflON OF DEATH T| DECEDENT UNDER 1 YEAR* AGE - Law Sa1h««v JR WILLIAMS N DONA D 1. SEX IASI MiDDlf (•» Exanguinating Hemmorrhage ”due to/or as a consequence of b«lw*,n O"»«l JM «•*! i Immediate .____ i„ (Immediate Gun Shot Wound To Head DUE TO. OR AS A CONSEQUENCE OF: jci * io a, 4th but not «aiaivd to u«w OTHER SIGNIFICANT CONDITIONS• Co**4*<oa» PART II AUTOPSY part i Yes Ho PLACE OF DEATH reuMM Amwancri “• irtom,. Nvtv^g Home. F (Specify) HOSP. OR INST . kxlctr OOA. OP (mm Rm AT HOME MfralmM EW (Signature and Title) (Mo.. Day. YrJ (Specify) lha b,V» of •a«nwi«t4n IM O< *«*tl4*l<0»l * m. *,««. tfaaib kC«<H al l«» to /Signature and Title) DATE SIGNED /Mo.. Def. Yr.i HOUR OF DEATH DATE SIGNED 23b______________ _____________ 23 c_______ /Typo Of Print) PRONOUNCED DEAD 24d 23d. NAME AND ADDRESS OF CERTIFIER iPhvscian on meoiCal ixamiMai h KENT BAILEY ACC SUICIOI HQM. NATURAL : OR PfNOWG WVtSI Si-^h' * 1LD. WJURY AT WORK /Mo.r<Dey. Yr.) PLACE OF INJURY-Al «tc \2«L-Nq_____________ 26f A,t Home BURIAL. CREMATION. REMOVAL. OTHER (Specify) cremation !Mo.. Day. YrJ »«MAY 28, 1986 _ COUNTY OF BARRY .1121 May 27, PRONOUNCED DEAD 1986 24* a.M /Hour) a. M 3:32 AT f*<tonr. #<l<e A5Q5Q6. GRAND RAPIDS, MI 32 Callbur Gunshot To Right Eye 2bc 12:30 a. LOCATION OTV. VlLLAGf. OR STRUT OR RID NO TOWNShiP SlATf /Specify) __________ 26g 190 Amasa CEMETERY OR CREMATORY-NAME _______ WREN-FUNERAL HOMEZ (Signature) (Signature)^ on 12:30 (Mo.. Day. Yr.) DESCRIBE HOW INJURY OCCURRED CENTRAL ”5--- MICHIGAN CREMATORY NAMtoffAdun voGT CHAPEL FUNERAL SERVICE. LICENSEE LICENSEE*-! STATE OF MICHIGAN) HOUR OF INJURY n^m.. I.tm, iut,i /Specify Yes or No) B-36a 6/83 EATH (Type or Print) 3970-WHISPERING WAY DATE OF INJURY —2±LHQUli£Li.d.e____ «■>. May- 2L4.9^& DATE R OF ?“..tay_au_122£____ M NAME OF ATTENDING PHYSICIAN IF OTHER THAN CERTIFIER 22r H 95 id X DISPOSITION Yas «21 24* 220 23*. Io th. bail «l •"< knoMiadga oa.in occm>M at IM f«M. oala a"d p«aca *M im chwiu naiad S5 (Specify Yes J WAS* CASE REFERRED TO MEDICAL or No) I EXAMINER’ (Specify Yes or No) j REGlSTrtSS / (Signature) Woodland.^ Mi__________ LOCATION OTV ViLLAGt. OR TOWNSHIP ADDRESS OF FACILITY 2()A 38b QUEEN NASHVILLE ^_ML X# STAT( 45073- |DATE/KCEIVED BY REGISTRAR I; Norval E. Thaler, Clerk of the County of Barry and of the Circuit Court thereof, the same being the Court of Record having a Seal, do hereby certify that the above Is a true and correct copy of the record thereof, on file In my office. Signed 'and sealed at H^rStlJigs, Michigan Thls.l.c??............. day of\ t-..Deputy By NORVAL E. THALER, COUNTY CLERK Clerk (Mo. Dai �No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Ronald Warren Rivett Date of death Full name of Cause of death Place of death________ Method of disposal 7-13-8519------ acute myocardial infarction Kent Walker ___ Race___ white b*ami <T™hWdb3TS?iH‘ft&norial Park (Whether burial, cremation, storage, etc.) . | County APPROVED FOR CREMATION - _______ M Age 50_ Wood! Signature of Medical Examiner chigan Date___________ —19-------- A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops Funeral Home hereby given to 935 Fourth Ave., Lake Odessa ArtHrew CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BEJ.OW Body ---------- 19 ________________ "" t jn------------------------------------------------ —------ __ L (Slate whether cremated, buried, stored. etc.)/j (Cemetpry or crematory) • (Sexton or person in charge) ' This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION I THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH FRANCES E. SAWDY—- ----------------------- Date of death April 1, 19 8$ Full name of Cerebral hemorrhage____________________________________ Cause of death Place of dnnth Washtenau Method of disposal _____________________ F. Chelsea Rm* white Aga_22_ Woodland Memorial Park-------------- Burial (Whether burial, cremation, storage, etc.) —----------------------------------------------------------------------- 1 CountyAPPROVED FOR CREMATION I ........ Signature of Medical Examiner '■ ■ —■ ----- (Cemetery or crematory^ gt<t1> Barry ■ - ■ ■—— Date , . Michigan — ■ 19------- - A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m Koops Funeral Chapel-------------(Funeral director. Address. Lake Odessa, Michigan erson acting as such) to dispose of body Tut* April 3 19-35— Mortuary Science Licensee) (Cheek cem^hSry or crematory authority shall fill out space below Body was-—19^j^, in . » (State whether cremated, buried, stored. ete-) (C^meteryi-br crematory) z < (Saxton or person In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) �I s 5 PERMIT FOR DISPOSITION OF HUMAN REMAINS i NAME OF DECEDENT SEX Richard G. Stambaugh Aug. lr 1913 Male PLACE OF DEATH-CITY OR TOWN PLACE OF DEATH—COUNTY (OR STATE IF NOT IN CALIFORNIA) Sacramento Sacramento | CALIFORNIA LICENSE NUMBER NAME OF FUNERAL DIRECTOR (OR PERSON ACTING AS SUCH) iF 136 Andrews & Greilich DATE OF DEATH DATE OF BIRTH Nov. 26, 1985 NAME AND ADDRESS OF SPOUSE OR OTHER INFORMANT Pauline Stambaugh 2209 Waterford Road Sacramento, Ca . 95815 TYPE OF PERMIT. CHECK ONLY ONE OF THE FOLLOWING TYPES OF DISPOSITION □ 8. DISINTERMENT AND REINTERMENT OF CREMATED □ 5. DISINTERMENT AND BURIAL (INCLUDES □ 1. BURIAL (INCLUDES ENTOMBMENT) REMAINS (INCLUDES INURNMENT) ENTOMBMENT) K 2. CREMATION AND BURIAL (INCLUDES INURNMENT) □ 6. DISINTERMENT. CREMATION. AND BURIAL (INCLUDES INURNMENT) □ 3. CREMATION AND DISPOSITION OTHER THAN IN A CEMETERY □ 7. DISINTERMENT. CREMATION. AND DISPOSITION □ 4. SCIENTIFIC USE □ 9. DISINTERMENT OF CREMATED REMAINS AND DISPOSITION OTHER THAN IN A CEMETERY OTHER THAN IN A CEMETERY FOR THE PURPOSE OF ISSUING THIS PERMIT. DISINTERMENT IS DEFINED AS THE REMOVAL OF HUMAN REMAINS FROM ONE SPECIFIED PLACE OF DISPOSITION TO ANOTHER SPECIFIED PLACE OF DISPOSITION. COMPLETE EACH ITEM REQUIRED FOR THE TYPE OF PERMIT SPECIFIED ABOVE AND INVALIDATE EACH LINE NOT REQUIRED FOR THE SPECIFIED DISPOSITION. NAME AND ADDRESS OF CEMETERY WHERE REMAINS ARE TO BE INTERRED | COUNTY BURIAL 1 I NAME AND ADDRESS OF CREMATORY WHERE REMAINS ARE TO BE CREMATED CREMATION MJJE^AND AQ^RESS OR CEMETERY WHERE REMAINS ARE TO BE INTERRED | COUNTY Woodbury Cemetery, -WbodhHay, ADDRESS. BURIAL AT SEA OR DISPOSITION OTHER THAN IN A CEMETERY OF CREMATED REMAINS NEAREST POINT ON SHORELINE. OR ! 3enia OTHER DESCRIPTION SUFFICIENT TO IDENTIFY FINAL PLACE AND COUNTY OF DISPOSITION This is to certify that 1 am the person having the right to control the disposition of the ACKNOWLEDGMENT OF APPLICANT SIGNATURE QLBERSON IN CHARGEPF^REMAZORY 12-2-85 East Lawn Crematory/ Sacramento, Ca. INTERMENT AFTER CREMATION DATE CREMATED remains of tho above named decedent under provisions of the Health and Safety Code, and 1 hereby acknowledge that trespass and nuisance laws apply and understand that 0 SIGNATURE OF APPLICANT ► DATE SIGNED this permit gives no right of unrestricted access to property not owned by me. SCIENTIFIC USE LOCAL REGISTRAR __ NAME AND ADDRESS OF FACILITY RECEIVING REMAINS _ r THIS PERMIT IS ISSUED IN ACCORDANCE WITH PROVISIONS OF AMOUNT OF FEE PAID THE CALIFORNIA HEALTH AND SAFETY CODE AND IS THE AUTHORITY FOR THE DISPOSITION SPECIFIED IN THIS PERMIT • uU CERTIFICATION OF PERSON IN CHARGE OF DISPOSITION // 1 CERTIFY THAT THE SPECIFIED DISPOSITION WAS MADE ON_________ t _________ ____ l// .__ DATE PERMIT ISSUED^. -efGNATUR^OF LOtfXL R^SlSTRARZfaSUING ► z 77 SIGNAfUREjOF PERSON IN CHARGE OF DISPOSITION____ S (ENTER DAlt) ' COPY 1 OF THE PERMIT ACCOMPANIES THE REMAINS TO THE STATED PLACE OF DISPOSITION. THE PERSON IN CHARGE OF DISPOSITION IS RESPONSIBLE FOR COMPLETING THE PERMIT AND FORWARDING THE COM­ PLETED PERMIT WITHIN 10 DAYS TO THE LOCAL REGISTRAR OF THE DISTRICT IN WHICH DISPOSITION OCCURRED OR TO THE LOCAL REGISTRAR OF THE DISTRICT NEAREST THE POINT WHBUfTHE CREMATED RE­ MAINS WERE BURIED AT SEA. COPY 1 STATE OF CALIFORNIA—DEPARTMENT OF HEALTH SERVICES—OFFICE OF THE STATE REGISTRAR OF VITAL STATISTICS (REV. 5-78) FORM VS-9 85 93650 �STATE OF FLORIDA DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES VITAL STATISTICS I APPLICATION FOR BURIAL-TRANSIT PERMIT A. (Type or Print) 1. Name of First Deceased Middle ZOE 2. Place of Death County ENID GUY City, Town or Location PASCO 3. Name of Medical Certifier WM. 4. Funeral Home/ Direct Disposer 5. Check Appro* priate Box C. Name of Hosp, or Inst. ZEPHYRHILLS CHANDLER, M.D, DATE OF DEATH Last 0 Physician Q Medical Examiner Month Day JULY 8. Year 1985 (If neither, give street address) ZEPHYR HAVEN NURSING HOME 905 6TH tftfteET ZEPHYRHILLS< FLORIDA 34248 Address Name KELLY FUNERAL HOME - 4 03 8TH STREET - ZEPHYRHILLS. FLORIDA 34248 a The medical certification has been completed and signed. A completed certificate of death accompanies this application. was contacted nn7/9/8.5— He/sK^zerified that b DR, CHANDLER this death was from natural causes, that there was no accident nor other external cause of death, and that --------HE will complete and sign the medical certification of cause of death. c medicalicettificati on. U 6. Funeral Director/ Direct Disposer Signature B ; / 4 Fla. Lie. No./Reg. No. 7 t X7O7 Date Signed BURIAL-TRANSIT PERMIT _____ .... . Permit No, , J-,.?.? _____ Permission is hereby granted to dispose of this body. * ■ ' ■ [X| A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted. If it cannot be filed within this time limit, a "Funeral Director/Direct Disposer Report" will be filed with the Local Registrar of the Count/ in which death occurred. (SUB) ^RSs^rSiflnawrd^(2Pd2v JULY 9, 1985 AUTHORIZATION for CREMATION, DISSECTION or BURIAL-AT-SEA c. Signature Medical Examiner Date ------------or Medical Examiner, , gave authorization by telephone tn L _________ —Funeral Director/Direct Disposer. Date The Medical Examiner's approval must be obtained before disposal by any of the above methods. Awaiting period of 48 hours after death is required for all cremations. CEMETERY OR CREMATORY D. Method of Disposition: BURIAL STORAGE CREMATION 0 OTHER (Specify) (SHIP TO: Signature oCgextorp) or Person-in-CKarge* ) Place of Disposi Date of Disposition ^7^ J VOGT CHAPEL OF WREN FUNERAL HOME ^^NASHVILLE, MICHIGAN) ^67 & This permit must be endorsed by the Sexton or person*in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the County where disposition occurred. HRS Form 326, APR. 81 (replaces previous editions which may be used.) �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION d BURIAL—TRANSIT PERMIT No---------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of Paul Wotring Smith Cause of death Natural Causes Place of death Antrim Method of disposal _____ Date of rfp«th May 26 19 85 __________________________________ Forest Home Two, Burial - »<■?« White Spy M Age_20— Woodland Memorial Park (Cemetery or crematory) (Whether burial, cremation, storage, etc.) APPROVED FOB CREMATION---------------------------- B,mf--------- - 1 C""» Signature of Medical Examiner _ _________________ Date 19 -— A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m Wren Funeral Home ana Hastings, Michigan 49058 Funeral director or person acting as such) to dispose of bod yr of said deceased.,^ / /I Date--------- MftY 27 Signature (Check Registrar, 19.05—- Q Funeral Directory K Mortuary Science Licensee) (&METERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was_l^ o^T^l ~^L.: — 19c^ji_ — S'" C.J (Cemetery or Crematory) 6 erX-si— Signature—___________ S' (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). , (State whether cremated, buried, stored^ etc. »zO (OVER)^^/ �MAINS TO DESTINATION l * ACCOMPANY W BURIAL—TRANSIT PERMIT Full name of deceased THIS PERMIT M l ACCOMPANY REMAINS TO DESTINATION J Date of death MRS. MTT.DRFD R- OSGOOD_________ —__________ June Cause of death___________Mesenteric Infarction__________ ________________________ T___________________ Place 01 death_____________ Barry_____________ Hastings Township Rnpa White F Agp 80 Method of dis osal_________lc°nnty) Burial (T°w",hlp or vi"w or Woodland Memorial Park Cemetery (Whether burial, cremation, storage, etc.) _ (Cemetery or crematory). APPROVED FOR CREMATION---------------------------- 1 Signature of Medical Examiner__________________________________________________ Date--------------------- 19--------- A certificate of death having been filed as required by the laws or regulations of this state, permission is " hereby given Richard A. Henry Funeral Home Inc/AHdrp„ ——rFtrrrts^l director or person acting as such) A ✓ (Check one: Date.______ JuD.e 17,_______ 19 85 ~ ' ' Battle Creek, MI________________ / to dispose of 45ody of said deebpsed. Signature^, CD Q Registrar, Funeral Director,Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was__ / 7 — v-z/____________________________________________________ in -v (State whether cremated, buried, stored, etc.lz^^ /*" / _ \ (Cemetery or-r^matory) Signature (Sexton or person in charge) / This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (0VER) BURIAL—TRANSIT PERMIT No___ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased_______ L Jean Potter_____________________________ Date of death July 6 19 85 _ cause Of death________ Cardio pulmonary arrest_______________________ .______________________________ Eaton_________ Charlotte_________________ Race white_____ gay F Place of death Age, 68 Method Of disposal_____________________ Buria]________________________ Woodland Memorial Park_______ (Whether burial, cremation, storage, etc.) ;,.™ovEDroR cremation” _ (Cemetery or crematory). Barry !■>* Signature of Medical Examiner_______ ______ ___________ *- . 19_____ Date -- — , Micbigan__ A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels,Inc. Address_______ Lake Odessa, Michigan (Funeral director or person acting as such) to dispose of body of sakf depeased,^ ' _ ✓ Signature_____ _______________________________________________________ r* CD THIS PERMIT M l No___ MICHIGAN DEPARTMENT OF PUBLIC HEALTH (ChecTTone: |j Registrar, fa Funeral Directof, Data July 9,__________ 1985 XJjMtrtuary Science Licensee) CEMETER^Dl( CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was__±^fcScS^L^s^ __________ on^^^K , _____ 19^211 in___________________________________ __ k "(State whether .cremated, buried, stored^etc.) (Cemetery or crematory) (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (0VER) a �this permit must accompany remains to destination TO1S permit must accompany rem ains to destination 1009K BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEAL7PH 85 Date of death ^epts Mabel Egelkroud Full name of deceased. Acute Cardiac Arrest_______________ SPY Female, _9_2 Wayne Detroit_______ Race White (Coun^) (Township or village or city) Woodland Cemetery Cause of death__ Place of death________ Method of disposal____ (Cemetery or crematory). . (Whether burial, cremation, storage, etc.) -------------- --------------------- 1 APPROVED FOR CREMATION Sta^ Michigan Barry -- ---------------------------- — Signature of Medical Examiner_____________ _______________ .—-------------------______ Date________ ______ brt. b..» .m .. wotai by «»■— " * WW «, WllMl. » .■ Colonial Ch^M-Bdward KoltoUn AJto. Mr.b, “■“ (Funeral/irector or person acting as such) OCT 1 1985^ OCT 11985 to dispose of Signature o Fun„., DIrMt.r, Michigan 48219 19. □ Mortuary Science Ltecn.ea) cemetery or crematory authority shall fill out space below ____________ a„(0c^2 Body was-- whether cremated, buried, stored, etc.p<7 A.\ _____________ ioZ-T / /J / ( (Cemetery OL^rematory) Rjgnntyre , f (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) No---- BURIAL—TRANSIT PERMIT Full name of deeaanad-... Cause of death MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 BRUCE HENDERSON ECKARDT Date of death Dec« £L»19^2_ Multiple severe trama head, chest, abdomen Barry___________ Hastings Place of death Method of burial , Race <T.wn,hip or viiingc or city) (Whether burial, cremation, storage, etc.) ■— ■ APPROVED FOR CREMATION Signature of Medical Examiner ■■■■ ■ » 1 [County-------- Sex-H— Age *>!_.. Woodland Memorial Park-. (Cemetery or crematoryX ^>.4 rtOf. — stat*Michigan Barry J °iml; 19.—... Date - ■- - • A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given t« Lake ^des3a> Michigan---------- Koops Funeral Chapels,Inc. (Funeral director or person acting as such) to dispose of body^fyaid deceased. y Signature_^5^ (Cheek one; Ff Registrar. f~yFuneral Director. Date — —30» — 19. .85 Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body wa« 3^ 19^-^ ((State yvhether cremated, burled, stored, e^c.)^ in—--------------------or ^•"’•tory) r Pla^JgrPr-X^z^/ /T^zz/^^P Signature/--------------1 (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). -^^^7 (OVER) <52^ . B-26 5/84 XJ \ �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased ROY MINER CROTHERS —------------------------------------- Date of death 01 /?1 __ 19.j85— n Infectious complications of Diabetes Mellitus I cause of deati}^^------------ LANSING-------------------- —-------------------------------- WHITE-------------- FT Place of death Method of ------- 44" BURlXrntr> ___ Race —.Sex .Age-------WOODLAOTl^gKr”^_____________________________ (Cemetery or crematory) (Whether burial, cremation, storage, etc.) BARRY | County APPROVED FOR CREMATION Stat* Signature of Medical Examiner MI 19 Date A certificate of death having been filed as required by the laws or regulations of this state, permission is GORSLINE-RUNCIMAN COMPANY 900 E. Michigan Avenue hereby given to--------- (Fiiner>, dlrectoror.ct,-n7^7u^------ Addr*“ Lansing,"Michiyan 48912-----------to dispose of bodyysft said~d^eased. W- Qa-t-t*******____________ n.t* Signature (Check^jne? Funeral Director, Registrar, 01-23-1985__________ 19--------- Mortuary Science Licensee) CEMETERY OR CREMATORY^UTHORITY SHALL FILL OUT SPACE BELOW Body was---- - ____________________________ onS^kSLi__ olJz___ 19/^5“ in //________________ \ (State whether cremated, buried, stored, etc.) . XL? . (Cemetery <f£rematory) s' 0i A / ^-^y^ignatiira (Sexton or person in charge) ' This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased JACOB DUITS______________________________ cause Of doath Congestive heart failure Place of dMth Barry Method of disposal Rapfl white Hastings ^Male^ 78_ Woodland Memorial Park __ Burial JUNE 3, 19 85 Dateof (Whether burial, cremation, storage, etc.) (Cemetery or crematory) Barry APPROVED FOR cremation---------------------------- 1 County st>fa“Hichigan Signature of Medical Examiner------------------------------------------------------- —------------------ Date 19-------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapel Address Lake Odessa > Michigan (Funeral director or person acting as such) to dispose of bodj^of said deceased) y Signature (Check one: --------------------- ----- Date. June 6 Mortuary Science Licensee) Director, CEME&SRY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was— on 6 yy fa4 X (State whether cremated, burled, stored, etc.) 1 Signature / (Cemefcrfy or crematory) f (Sexton or person In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (°VER) qI �I PERMIT FOR DISPOSITION OF HUMAN REMAINS / NAME OF DECEDENT Gertrude Price Barnum FpmalA___________ PLACE OF DEATH-CITY OR TOWN PLACE OF DEATH—COUNTY (OR STATE IF NOT IN CALIFORNIA) Escondido San Dieqo NAME OF FUNERAL DIRECTOR (OR PERSON ACTING AS SUCH) ] CALIFORNIA LICENSE NUMBER Alhiser-Wilson Mortuary DATE OF DEATH DATE OF BIRTH SEX 297 tian. 1. 1898___ Jan. 17. 1985___ NAME AND ADDRESS OF SPOUSE OR OTHER INFORMANT Dorothy Kline 467 Nantucket Glen Escondido, CA 92027 TYPE OF PERMIT. CHECK ONLY ONE OF THE FOLLOWING TYPES OF DISPOSITION □ 8. DISINTERMENT AND REINTERMENT OF CREMATED □ S. DISINTERMENT AND BURIAL (INCLUDES □ 1. BURIAL (INCLUDES ENTOMBMENT) B 2. CREMATION AND BURIAL (INCLUDES INURNMENT) □ 6. DISINTERMENT. CREMATION. AND BURIAL (INCLUDES INURNMENT) □ 3. CREMATION AND DISPOSITION OTHER THAN IN A CEMETERY REMAINS (INCLUDES INURNMENT) ENTOMBMENT) □ 9. DISINTERMENT OF CREMATED REMAINS AND □ 7. DISINTERMENT. CREMATION. AND DISPOSITION □ 4. SCIENTIFIC USE DISPOSITION OTHER THAN IN A CEMETERY OTHER THAN IN A CEMETERY FOR THE PURPOSE OF ISSUING THIS PERMIT. DISINTERMENT IS DEFINED AS THE REMOVAL OF HUMAN REMAINS FROM ONE SPECIFIED PLACE OF DISPOSITION TO ANOTHER SPECIFIED PLACE OF DISPOSITION. COMPLETE EACH ITEM REQUIRED FOR THE TYPE OF PERMIT SPECIFIED ABOVE AND INVALIDATE EACH LINE NOT REQUIRED FOR THE SPECIFIED DISPOSITION. jCOUNTY NAME AND ADDRESS OF CEMETERY WHERE REMAINS ARE TO BE INTERRED BURIAL I ____ na___________________________ _______ ___________ NAME AND ADDRESS OF CREMATORY WHERE REMAINS ARE TO BE CREMATED DATE CREMATED ' ~ SIGNATURE OF PERSON IN CHARGE OF CREMATORY CREMATION . Eternal .Hills Crematoi^/Orpansides CA. JanT18.1985 INTERMENT AFTER CREMATION NAME AND ADDRESS OF CEMETERY WHERE ftfeftAINS ARE TO BE INTERRED I COUNTY Woodland Memorial Park/ Woodland Michigan_______________________ !Barry_______ ADDRESS. BURIAL AT SEA OR DISPOSITION OTHER THAN IN A CEMETERY OF CREMATED REMAINS NEAREST POINT ON SHORELINE. OR OTHER DESCRIPTION SUFFICIENT TO IDENTIFY FINAL PLACE AND COUNTY (fr DISPOSiTiON na This it to certify that I am the person having the right to control the disposition of the - ACKNOWLEDGMENT OF APPLICANT SIGNATURE OF APPLICANT remains of the above named decedent under provisions of the Health and Safety Code, and I hereby acknowledge that trespass and nuisance laws apply and understand that DATE SIGNED this permit gives no right of unrestricted access to property not owned by me. SCIENTIFIC USE LOCAL REGISTRAR NAME AND ADDRESS OF FACILITY RECEIVING REMAINS THIS PERMIT IS ISSUED IN ACCORDANCE WITH PROVISIONS OF p AMOUNT OF FEE PAID DATE PERMIT ISSUED _tkQ0______________ JAN 18 1985 THE CALIFORNIA HEALTH ANO SAFETY CODE AND IS THE AUTHORITY FOR THE DISPOSITION SPECIFIED IN THIS PERMIT Certification OF PERSON IN CHARGE OF DISPOSITION : { 1 CERTIFY THAT THE SPECIFIED DISPOSITION WAS MADE ON %______ I (ENTER DATE) ___ SIGNATU JE OF LOCAL REGISTRAR ISSUING PERMIT SIGNATU TrOF "PERSON in CHARGE OFl)ISPOSITI0ft COPY I OF THE PERMIT ACCOMPANIES THE REMAINS TO THE STATED PLACE OF DISPOSITION. THE PERSON IN CHARGE OF DISPOSITION IS RESPONSIBLE FOR COMPLETING THE PERMIT AND FORWARDING THE COMPLETED PERMIT WITHIN 10 DAYS TO THE LOCAL REGISTRAR OF THE DISTRICT IN WHICH DISPOSITION OCCURRED OR TO THE LOCAL REGISTRAR OF THE DISTRICT NEAREST THE POINT WHERE THE CREMATED REMAINS WERE BURIED AT SEA. COPY 1 STATE OF CALIFORNIA-—DEPARTMENT OF HEALTH SERVICES—-OFFICE OF THE STATE REGISTRAR OF VITAL STATISTICS (REV. 5-78) FORM VS-9 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT No—------------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH 1t) 86 Fun name of derenwd Harry Raymond Woodman cause of death Place of death Acute myocardial infarction------------------------------------------------------------------ Kent Grand Rapids W s„ M Agp88 Method Of di^el Date of rf^th Mar.27 (Townahlp or village or clty^ood j an^ Wai (Whether burial, cremation, storage, etc.) | County APPROVED FOR CREMATION Cemetery (Cemetery or crematory) State. Michigan Barry Signature of Medical Examiner Date 19 _ A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to_ Ronan VAnderpoo 1 Steqenqa (Funeral director orperapn acting as such) Address Address. Wyoming, Michigan to dispose of b4dy/6f said rtprppqp^^y y . Signature (Chee 2/Q Registrar, □funeral jyirector. ______________ Pate-March- 29 19 86_ tortuary Science Licensee) CEMETERY OR CREMA/TdRYZAUTHORITY SHALL FILL OUT SPACE BELOW Body was. on. in. -'s*— Signature Pla< • (Cemetery or crei (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) �.u r THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Ut ’465 BURIAL—TRANSIT PERMIT No._________ MICHIGAN DEPARTMENT OF PUBLIC HEALTH 19 86 Full name of deceased. Cause of death_______ ARTEROSCLEROTIC CARDIOVASCULAR DISEASE DEARBORN D WHITE o F A<r« . 70 __________________ Race_______________Sa* BUR3WL (Township or village QIAND ’.CCSMETERY WAYNE _______ Place of death___ Method of disposal__ AnwYfiU FOR CREMATION (Cemetery or cremat^j^Q^j (Whether burial, cremation, storage, ctc-WOODT AMD "T Count*______________________ 1 ■ ■■ - * ■ ________ - Signature of Medical Examiner -------- Date—___________ 19_____ A certificate of death having been filed as required by the laws or regulations of this state, permission is u u LESNEY & SON FUNERAL HOME. t hereby given to_______________________________ 2 13201 W WARREN MICH. Address___________________ ________ (Funeral director o£ person acting as such) to dispose of body of said deceased. APR 2 8 1986 Signature_____________________ (Check one: (^Registrar, Funeral Director, _______ , _______ Date. —us___________________ 19. Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was.2? ... | (State .whether cremated, burled, •t^reA eto^/ * / tS? (Cemetery’or crematory) Q Signature.jJejfcL-^£l^ae<-s^Lj£zE^®tfi-^--------------- ~— (Sexton or person in charge) • This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (over) B-26 5/84 3 -6J- y 7 y �BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 ETHEL NEEB________________________ Date of — Oct 16 1986— Respiratory Failure_________________________________________ Barry Hastings Rftpa White 8av F Aga79_ Burial Woodland Memorial Park Full name of deceased Cause Of death Place Of death Method of disposal (Whether burial, cremation, storage, etc.) APPROVED FOB CREMATION (Cemetery or cremataurLi. oan Rflrr.v ' I County ' ------- stat* Signature of Medical Examiner ~ Date 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops Funeral Chapels, Inc. hereby given tn 935 4th Ave. Lake Odessa, Mich. 48849 Funeral director or person^ctlng as such) to dispose of body of^Zaid jdfxfeased. October 20, Signature. 19-86- uary Science Licensee) cemetei^/6r crematory Authority shall fill out space below Body Waa*r^C4x£-CX^^.AO 19. .on: in. (Cemetery or crematory) (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B*26 5/84 STATE OF ARIZONA TRANSIT COPY (This copy must accompany body to final destination) 1 DEN • 1 r 1CA I ION OF DECEASED AND PLACE OF a. MIDDLE • C. LAST Owen PLACE OF DEATH ^December 17, 1986 «St. Joseph's Hospital CAUSE OF DEATH —- [3 SEX AGE 2Male ,.72 Tucson onO J rAce or COLOF 4t White C. STATE a, c6UnTV A. TOWN OR Cl fY DATE OF DEATH Pima Arizona (MUST BE COMPLETED IF BODY IS SHIPPED OUT OF STATE. MOVED SY COMMERCIAL CARRIER, OR A DEATH FROM CERTAIN DISEASES) Q BURIAL MANNER BURIAL-TRANSIT PERMIT_________ A. First Lincoln NAME OF DECEASED REGISTRAR’S ?ILE NO. DEPARTMENT OF HEALTH SERVICES - VITAL RECORDS SEC TION Q OTHER (SPECIFY) CREMATION "TtfNERAL HO^;mcTNC. n ".......... ..Brings Broadway Chapel, P.O. Box 1423, Tucson, Arizona 85702 FUN ER REMOVAL e. of Cremains 10F DATE SIGNED S SIGN R580 ( ,12-22-1986 A. liAME^ DISPOSITION i2. Pickens-Koops, 935 4th, ’ Lake Odessa. Mie 48849 DEAD HUMA REGISTRAR'S AUTHORIZATION ATE SIGNED FOR DISPOSITION December 22. 1986 CEMETE.. CREMA.TORY DISPOSITION CEMETERY MANAGER'S SIGNATURE OF BODY 20. daTE HCV'B. Ik ST‘A £ bFFlCE IREGISTR AR%SIGN ATURE STATE REGISTRAR USE VS-7 REV. 7-74 21 22B. 22 A, CEMETERY MGR.: MAIL TRANSIT COPY IN 10 DAYS TO VITAL RECORDS. P.O. BOX 3887 DEPARTMENT OF HEALTH SERVICES, PHOENIX. ARIZONA 85030 �(616) 982-0333 (517) 374-6656 (616) 963-1554 P.O. Box 1031 Battle Creek, Ml 49016 CENTRAL MICHIGAN CREMATORY CREMATION CERTIFICATE NAME Charles L. Faul ________ __ SEX Male WAS CREMATED AT CENTRAL MICHIGAN CREMATORY ON MONTH September DATE OF DEATH FUNERAL HOME 23" DAY 1986 YEAR September 20, 1986 ____________________ Wren BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased Cause of death Place of death Method Of diqnnsni H. 1f>86 RUTH FISHER____________________ Date of d«wthB6C. Myocardial infarction______________________________________________ Barry woodland Twp. rbph White 9pv F Agfl93 (C°anty> Burial ^I^Land Memorial Park Cemetery (Whether burial, cremation, storage, etc.) I County----- APPROVED FOR CREMATION (Cemetery or crematory) Barry Date Signature of Medical Examiner , state ■I^LC lqan 19 A certificate of death having been filed as required by the laws or regulations of this state, permission i hereby given tn THOMAS R. SHAW (Funeral director or person acting as. such) Address 121 Capital Ave., N.E. Battle Creek/ Michigan 49017 to dispose of body of said deceased. ■Sir'^ture — (Check one: O Registrar, Funeral Director, __________________ n»t» December 17, 1986 3 Mortuary Science Licensee) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER)^/^^ yo �BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 GENEVA N • BRANDT ------ — Date of deathjlaD—31»— 19 86 Full name of deceased ___________________ Cause of —■ Barry Hastings - Race—W---------- Sex_E----- Age86— Burial__________________________ Woodland Memorial Park (Whether burial, cremation, storage, etc.) (Cemetery or crematory) ■■■■ ■■ Qnnfv Barry____________ state Michigan _ Place of death Method of disposal ■■■-— I b APPROVED FOR CREMATION y----- ----- ■— ______________________ Date—- ---------------- 19-------- Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops Funeral Chapels,Add?*™ Lake Odessa, Michigan hereby given to (Funeral director or person acting as such) to dispose of body of said deceased. n.t. Signature—>----(Check one: R^fristytr, 19_86 February 3, (20 Funeral ^Hrectqff X) Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW fc BURIAL—TRANSIT PERMIT O p MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 •< £ 55 No Full name of derWed d^Nov. 17 19 86 Norman Cairns Respiratory Failure Emmet Levering w Q Cause Of rtpnth O Place of death 00 Method of disposal__ «< x APPROVED FOR CREMATION M 06 Signature of Medical Examiner (County) — . _ Burial - Race White gpy M Ag<^7 (Township or village or city) (Whether burial, cremation, storage, etc.) *] County (Cemetery or crematory) --■ -____________ _ state , . Michigan ______________________—Date —19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given te Koops Funeral Chapels,Inc, Addrw Lake Odessa, Michigan (Funoral director or person acting as such) to dispose of body of said decease^. Signature. (Check one: JCegptrar, i Q. Funerajr Director JQ Mortuary Science Licensee) D»u November 19, 19.86 CEMET&tY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW fc:1 • Body was—~ £ 06 W fttn £ (State whether cremated, burled, stored. etc.)rj . ___ ~ * (Cemetaf^or crematory) (Sexton*or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). B-26 5/84 <0VE",/^r3- -a-t �No. BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 \ Full name of deceased Cause of death Feb. 9, FRA.NK_VINCENT BARRY _ Squamous cell carcinoma of lung Place of death------------Barry----------------- Hastingsn (County) .. - . 86 __ Bapa White M A(rK > 73 ____ ____ Woodland Memorial Park (Township or village or city) Method of disposal----------------------------- purial (Whether burial, cremation, storage, etc.) -------- io (Cemetery or crematory) I County------ APPROVED FOR crfmatton Barry Signature of Medical Examiner State. Date , . Michigan _______ 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to Koops Funeral Chapel Address Lake Odessa, Michigan (Funeral director or person acting aa such) to dispose of body Signature—., (eKeck one: . said deceased. - 19—86 ------------------- Date______ Reg I Mortuary Science Licensee) CEMETEfctf OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body ---------t on.^J# Z=S___ 19^ iSUte whether cremated, burled, stojed.^te.)^ , /■) z ______________ (Cemetery o^Veihatory) (Sexton or person In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Full name of deceased. Cause of death— Place of death BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 ofJ 980 Date Of deathZ^>7* - LyPlPHortA S'HEP/lfiD Race— kJ L.UNG .ISABELLA (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION----------------------1°™* rj a n i") i i i — Sex7SLa8.^7. (Cemetery or crematory). » ^A£^_ Signature of Medical Examiner SUU / / 19-------- Date ^certificate oCdeath Jjavjpe been filed as required by the laws or regulations of this state, permission is hereby given tn $4 (Funeral director or person acting as such) to dispose of^jody of s^i^dec^ased^ ) z*7^* z*"^o • Signature^ f CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW / (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION 5/84 BURIAL—TRANSIT PERMIT Ho MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Full name of deceased— LUCY E, VELTE _ _ Date of death Nov_«—Zx 19 Cause of death PncumoniB Place of death Barry______________ Hastings ’ Burial Method of dieposaL— Sex Race_^ (Township or village or city) (County) . 8Z. LAge_§£. i r> i Woodland Memorial Park--------(Cemetery or crematory) (Whether burial, cremation, storage, etc.) | County------ Barry APPROVED FOR CREMATION Signature of Medical Examiner, . State 1C ________________________ Date Ka _ ___ _ 19--------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given t» Lake Odessa, Michigan Koops Funeral Chapels, Inc. (Funeral director or person acting as such) to dispose of body of said deceased. Signatnw, / -------------------------- n.r, Nov. 9, 1987_____ 19------- XT (Check one: Body was. * rf/fiegistrar.O Funeral Doctor, Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACER BELOW fob 19^7 in ------------------ — *. (State whether cremated, buried, stored, etc^ ’ - z/£ 1 £ (Cemetery ^Fcrematory) (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) ($2^3 B*26 5/14 I 7 �BURIAL—TRANSIT PERMIT No-------------------------------------- MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 MARTHA V, SMITH Date of deathJtay_lAx 19SZ__ Full name of Carcinamatosis------------------------------------------------------------------------------------- -- ■ Cause Of death Barry__________________ Woodland Two.— Race—Whit?------ Sex—?— Age_§_ Burial <Tw"-hl-<)rvlllw<irclty> Woodland Memorial Park (Whether burial, cremation, etor.ee, etc.) Barry' (Cemetery crematory) j^gan Place of death ... . ,SP°88 APPROVED FOR CREMATION I County ~ —-----------------------Signature of Medical Examiner----------------------------------------------------------------------------- ®ate------- -------------- 19--------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels,Inc, Lake Odessa, Michigan Addrw 19_82_ This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) j jg B-26 5/84 Full name of derenged BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH . Act 368 of 1978 and Act 299 of 1980 Wilda K, Swanson Date of death Aug<—18.19-87-.. Congestive heart failure_______________________________ Cause of death Ingham Place of death Method of disposal Lansing White SptF.. Age.84 (Township or village or city) (County) Woodland Cemetery Burial________________________ (Cemetery or crematory) (Whether burial, cremation, storage, etc.) ~1 County-Barry APPROVED FOR CREMATION Signature of Medical Examiner .... - ■ State Mi chi gan — —_______________ Date . 19--------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to Estes=Leadljey Co. Address—Lansing,-MT-------------------------------- (Funeral director or person acting as such) to dispose of hdS^ of saidsdeceastfd. August 18, Signature ((fiieck one: Registrar. Funeral Director, 19_87_ Q Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 �BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH BE» WW 299 °'1980 . Cause of death Place of death. Method of disposal . , .. Oct._____ 2219_____ 87 Date of death - Full name of deceased. Resp. Arrest Hastings Raffl White F Age§2 Barry (Tpwnshjp or village or city) (County) ________ Burial __ Woodland Memorial Park (Whether burial, cremation, storage, etc.) n (Cemetery or crematory) • . ------------------------- 1 County Barfy Stat* Michigan APPROVED FOR CREMATION Signature of Medical Examiner. Date. 19. A certificate of death having been filed as required by the laws or regulations of this state, permission is hpn.hy s O Q m Koops Funeral Chapels, Inc. AdHr„, (Funeral director or person acting as such) to dispose o of said 935 4th Ave. Lake Odessa, Micl 48849 nah, October 26 Signature i rec tor, Registrar, CO P 19.81. ©'Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW * Body was. S 19. .(State whether cremated, buried, stored, etcJ^ s (Cemetery . crematory) Signature. w (Sexton or person in charge) co This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). x B-26 5/84 MEMBER: MICHIGAN CEMETERY ASSOCIATION AMERICAN CEMETERY ASSOCIATION NATIONAL ASSOCIATION CEMETERIES NATIONAL CREMATION ASSOCIATION INTERNATIONAL cremation FEDERATION NATIONAL LOT EXCHANGE INTERNATIONAL LOT EXCHANGE PHONE (616) 949*0660 4341 CASCADE ROAD S.E. GRANO RAPIDS, MICHIGAN 49506 GRACELAND MEMORIAL PARK AND MAUSOLEUM ✓ 9.S.9e....T. Name of Deceased......*. Hastings, MI Place of Death. Barry County Ag.,________________________»!_________ ___ —______________________ __ ________ 0.1. of 0..1K— _____________________________________ August 6, 1987 Date Received.........--------------------------- * n , ------------- -——------------------ ----- ------------------------------------- August 10, 1987 . Date of Cremation................... ................................. Destination of Cremains Cause of Death. r i Funeral Director, Wogdlandu .Mich. / ^ro^^ulmpnary, Arrert Koops Funeral Chapels, Lake Odessa, MI - ...... —~.— ..... �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 JESSE R. MULFORD __________________ nat<» nf death Widespread Metastatic Cancer Washtenaw Ann Arbor (County) (Township or village or city) Burial Cause of death Place of death Method of disposal No (Whether burial, cremation, storage, etc.) APPROVED FOB CREMATION----------------------- ~l Aug .11^87 White M Ag„ 67 , Woodland Memorial Par rbpp — (Cemetery or crematory), <*“» - - . --------- Signature of Medical Examiner 19 Date A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m Koops Funeral Chapels, Inc, Address (Funeral director or person acting as such) to dispose of bodv of said deceased Signature 935 4th Ave, Lake Odessa, Mich 48849 —, V August 14, i987_ O^Mortuary Science Licensee) (Chee' CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). ZJ? 5~ (OVER) THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION B-26 5/84 BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Full name of dpne»H<>d DONALD D. MURPHY Date of CARDTO-RESPIRATORY ARREST BARRY HASTINGS TWP, (C°Unty> BURIAf<>wn,h"‘orvlllw°rc'tl,) Cause of death Place of death Method of di,^«i APPROVED FOR CREMATION (Whether burial, cremation, storage, etc.) * County 7~30 m 8? _ _ Bbpb WHITE gPY M Ag> 84 WOODLAND______________ BARRX (Cemetery or crematory) . Signature of Medical Examiner . State-— Jl. Date -■ 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn AdrirBBB WREN FUNERAL HOME (Funeral director or person acting as ouch) / to dispose of body of said d&cea/Jd. . A Signature_____________ Z L-Z (Check one: Registrar, _ HASTINGS, MICH / JULY 31 ________________________ 19 C Funeral Director, 8? wf Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was----- ____________________________ affiufy ___ 19^7—An_______________________________________ (State whether cremated, burled, stored, etc,) —«f ^7 . (Cerrmjeryor crerftatory) Sign«ture^3^!4&±£^C--^^2^2=S=i___ (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science~licensee^where there is no sexton). (OVER) B-26 5/M ^3^ ? v ' Jig <-> �CERTIFICATION OF A .FETUS' BORN MIpHIGAN DEPARTMENT-OF/PUBEIC.’HEALTH '?S/ '■ • ;■ Office, of the State ReaiStrar & Cenier for Health-Statistics-;, fgjfus'ofc *!c WS'g--Wijlk By Authority of Act 368, P.A;. 18(76^ .YaT* /. ,Narne'of Fetus:;. A Mat- Randy ;Allen McElhaney nxt lcm . •: / 1R jR deanfl/nh•V; Fat^s Faiun-i^ oi'not; rnbrtlhhart.iff.000^)0 sr.bQtfc* .• ':S' ■ ; Siflnpfyrfl;/ SJVTF?. (Aftondaqt).:^*;^ </Pla$e%of /Delivery: < I k? fr M AM •">: '7.i£' • (County);^ .?•. '• . /Method.of.finar disposition -fpheck one): •: ‘ •,:**;*; .■•" ; \’(To(wnship .or yil.^ge or City) ‘ Burial . ‘.O Cremation.; -Q Storage*:f<^/po6atign/^O^^0h *** • \ 7« -i * * i •_;FOfj> CREMATION ■ BY; S|J ...' (Signature ofi Medical' Examiner) 7t;A.UTHORIZATl6N:;l50R..Fl'NAL<DlSPdsiTION.iOF- SAID FETUS IS; GIVEN-'BY; ^fe'-fefe'^-’N'ame :' PlCEWS AkTb ECQpJ (CHECK-ONE).Gfl MORTUARY SCIENCE LICENSEE INSTITUTION DIRECTOR < □,AGENCY^AUTHORIZED;Tp^Ct^.t:DQNATEp...BOE>tES >». <3’0.08ture of* Mother- a < > jeSz r i Signature.’ of; Father' Date: c u. "S June. was on v 7a>“‘ •<M\ pbtna?-Bagiy:;V';\ :/\ 1 • ' *' ’ 8_\ . ’■ > '• >• ^<*."**\.* *• Woodland Memorial Park i9_fiZ_ in ■ ••y f v**:’*■-•*-• Woodland ;signature (Township oGVillego or City).•.'>-/• .. .»(County) < Vr'^p*4» <j. MORTUARY SCIENCE L!CEh|SEE OR FACILITX-.USE .i •**••*’** j%*‘?*/*’; *aV*** *J* ' - i. jop/petwy. i-i . i I’-,*., .\?\.'TyMortuar^^enceHcenUe,oi^n8t'tulMn, Director)-, \ /*e fy**1 i*i\p •; *? ***#v *. State Form 36423 nSMIT FOR DISPOSITION OF HUMAN RIMAINS INDIANA STATt SOARD OF HEALTH pcrnit NANS OF DKCKASKD Meadows, Edith C sex February 25, 1987 COLOR OR RACK Female White AOL 91 PLACK OF OCATN fCtty ST teNRubip/ rkmoval fStatel fCesRCy/ Decatur, Adams, IN (City er town«Mpt smsIx, State/ NAMK OF CCMCTCRY OR CRKMATORY CRKMATION 34 BURIAL No : (MUdlf) (Pint) (L*ll) ( <>TMrR Burial fSpfdh) HAMt OF FUNtRAL CSTAOLISHMtMT Zwick-Boltz & Jahn Fun'rl Home PROPCRLY KXKCUTCD CKRTIFICATS OF OCATN Woodland Cemetery, Woodland, Michigan SUSINCSS ADORSSS 520 No, 2nd St., Decatur, In BURIAL TRANSIT PCRMIT ISSUKO FROM PROVISIONAL CKRTIFICATK OF nrtTW RCCCIYSO,................ .. „ A CERTIFICATE OF DEATH OR PROVISIONAL CERTIFICATE OF DEATH baviRff beta IM sa ressirta by lav. permiMtea la hereby MvbR ter traaaperteUea aa4 ' diepeeitiea el tbit bedy. StONATURK OF LOCAL offickr (AUvtt) OATS issuco TMaatA. say, pasr/ February 25, 1987 OATS OF INTKRMCNT, CREMATION OR llcMOVAL SISNATURK OF SCXTON OR PKRSON IN CNAROC February 28, 1987 MM MOW J>ZoT -&J-33Z �This certifies that ZELPHA KJOL March 24, 1987 WHO DIED ON THISC WAS CREMATED at the SOUTHERN MICHIGAN CREMATORY SERVICES, 2323 Brooklyn Road, Jackson, Michigan. ON —March 26,—1982---------------------------------- SOUT MICHI CREIV SER V( Reg No. .525 4 * MANAGER k DIVISION OF WILBEE CONCRETE PRODUCTS CO. THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION JACKSON, MICHIGAN BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Floyd G, Mahler______________________ Date of deathJuly 22_ 19_§Z_ Full name of deceased Cause of death__________________ Cardi n-Kespi ratory Arrest-__ ___ _______________ r-----------------------------Place of death Gratiot_____________ St, Louis Race White seyMale Age92,.„ , ' (Township or village or city) (County) Burial Method of disposal Woodland Memorial Park (Whether burial, cremation, storage, etc.) I <*>»«>* APPROVED FOR CREMATION (Cemetery or crematory) Barry ■ ------- State Michi8an-------_Date Signature of Medical Examiner 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given Stebbins & Simpson F.H.Inc, 518 N, Camburn St, Stanton, MI. t 48888 Address. (Funeral dlr^cjor or person acting as yuch) to dispose of body of said deci Signature. (Check one: Registrar, Funeral Director, Wm Date. ry Science Licensee) July 25 19_&Z_ CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/M y 2/2 �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT M78 MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Clair Maxwell Fuller Dateof death Full name of Jan, 8 iq_87 Cause of death------------------------------ Acute respiratory failure Calhoun_____________ Battle Creek Place of death White (Township or village or city) _ remation (Whether burial, crematigp, storage, etc.) APPROVED FOR CREMATION q^Y M Age 81 _ Oak Hill Crematory (Cemetery or crematory), , 1 — State “nty’ ------ 7 • Signature of Medical Examiner-----pntA A certificate of death having been filed as required by the laws or regulations of this state, permission is Farley-Estes Funeral Home , <F“;T‘ 7 cr p*™" “ "•h) hereby given to . tu u aami to dispose of body of said deceased* 1Q5 Capital Ave,, N.E, Battle Creek,r MI 49017 Signature—04^'5^ (Chftfi one: not# Funeral Director, Q Registrar, January 9 1987 QJ Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was—C^ E/y) ft TED----------------- on JO Jflhl piac«—Battle IJ Creek—.— h-\ _______ 19£2_^nz,OfiK HjLL (Slate whether cremated, buried, stored, etc.) N £"fCemXyfr or crematory) --------------- m/^^^sr — signtty CWg, mA iA^^ex^n or person In charger This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton), -ar ^7 /? BURIAL—TRANSIT PERMIT Full name of deceased Cause of death Place of death Method of dtapmi No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Ward W, Jordan_________________ ____ Date of death Respiratory failure Kent Grand Rapids Burial (Whether burial, cremation, storage, etc.) Cnnnty | vwnwy --------------------------------------------------------------------------------------------------- 1 APPROVED FOR CREMATION Jan, 18,ip_87— _ ;________________________ ____ R»ca White ger M Age 74— Woodland Memorial Park . (Cemetery or crematory), , Barry Stete Michigan nniiy ows^ ° — Data Signature of Medical Examiner 19-------- A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given m Lake Odessa, Michigan Koops Funeral Chapel (Funeral director or person acting as such) to dispose of body,at said deceased^-^ x Signature (CKeclTone:Q R^sfrar, 7 cX Funeral Jblrecto^ " Mortuary Science Licensee) Date January 21, 19.87 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. . i .on. (State whether cremated, buried, stpred, etex (Cemetefyor crematory) t Signature. (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/84 / 76 �BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 JOHN JOSEPH BLACK ___________ Date of death Full name of riwwwdCause of death No 9~7— 87 19 RESPIRATORY FAILURE Place of death Rare GRAND RAPIDS KENT WHITE sPy M Age 68 (Township or village or city) (County) Method of disposal WOODLAND MEMORIAL PARK _ BURIAL (Cemetery or crematory) (Whether burial, cremation, storage,'etc.) ------- State- MTGH .BARRY [County.. APPROVED for crfmation - 19 Date Signature of Medical Examiner A certificate of death having been filed as required by the laws or regulations of this state, permission is WREN FUNERAL HOME hereby given te HASTINGS, MI Addreaa to dispose of body of Signature. (Check one: CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW 21 This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). ,0VB"> ti&r 7 £0-^, /A „ BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 ABRAHAM MARK BRODBECK JR. Full name of Cause Of death Shock Cardiorespiratory arrest Kent Place of deeth Aug, lln»87 ____________ Grand Rapids__________ RnPfl White qPY M AgP2 Wk (Township or village or city) (County) Method of disposal Burial -- ------------------------------------- Woodland Memorial Park (Whether burial, cremation, storage, etc.) County 1--------Signature of Medical Examiner — (Cemetery or crematory) __________________ State— — —----------------------------- - --------------------- Date ..-ZZ 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given te Koops Funeral Chapels.Inc.«_ Address. (Funeral director or person acting as such) to dispose of body Lake OdessaMirh said deceaseds ___ ___ ) &—Date. Signature.___ (Check one: Registr £'Funeral Director. [J^Rortuary Science Licensee) August 13 19-87 CEMETERY (#R CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was. (Cemetery tfr*terematory) Plal (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) B-26 5/M 'M' ' $2- �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT Full name of deceased Place of death Method of disposal __ SpT F Bare White Hastings 24, jg 87 80 (Township or village or city) (County) Woodland Memorial Park (Cemetery or crematory) . Barry 0^^ Michigan Burial ■—■■■■ ■ —| (Whether burial, cremation, storage, etc.) ' APPROVED FOR CREMATION I 8tate Signature of Medical Examiner -------- Date —■ 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn Koops Funeral Chapels, Inc. (Funeral director or person acting as such) Addreaa 935 4th Ave. Lake Odessa, Mich 48849 Date. August 26, _i9_87 CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) 1-26 THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION Cardiopulmonary Arrest Barry Cause of death No_ MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 HILDA A« BAAS Date of death Aug * y 5/84 BURIAL—TRANSIT PERMIT •Full name of deceased Cause of death MICHIGAN DEPARTMENT OF PUBLIC HEALTH . Act 368 of 1978 and Act 299 of 1980...,,• ,. . CLAUDE F. BACKE ■ . Date of death ■ CARDIAC FAILURE ; Place of death KENT 3—ll— iq 87 ■ Rare WHITE GRAND RAPIDS Rev M Age-SD_ (Township or village or city) (County) Method of disposal No. BURIAL_______________________________ WOODLAND MEMORIAL PARK (Whether burial, cremation, storage, etc.) [County---- APPROVED FOR CREMATION . (Cemetery or crematory) State MICH BARRY Date Signature of Medical Examiner . 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tQ WREN FUNERAL HOME Add™** HASTINGSj MICHIGAN (Funeral director or person acting aa such) to dispose of body of said deceased. Y Signature__________ —r_______________________________________________ _ Date_______ MAR’ 12_______ 1<?7 (Check one: Registrar, Mortuary Science Licensee) r~l Funeral Director, CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body wan » on-Z2^i^l—ZsX- 19d^7 (State whether cremated, burled, stored, etc.k^r • g Sj ' . fo- \ (Cemetery o^Frematory) (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). (OVER) �No Full name of deeeeeed Cause Of death Place of death. Method of disposal LETHA BELLE SOUTHWELL n.t).nf May 3, 1fl88 Cardiopulmonary Arrest___________________________________________ Barry Woodland Twp. r»™ White F Age 62. (County) BurTalh'P °r vlll**e clty>______Woodland Memorial Park (Whether burial, cremation, storage, et^) APPROVED FOR CREMATION (Cemetery or crematory). Signature of Medical Examiner. - . _____ State Michigan * ~~I County ■ ■.. - -__ - 19 Date A certificate of death having been filed as required by the laws or regulations of this state, permission is Koops Funeral Chapels, Inc, hereby given Address (Funeral director or person acting as such) to dispose of^bodysof said deceased, 935 4th Ave, Lake Odessa, MI 48849 a Signature \ ________ Date (CheclTone: Q Registrar, Q/i’uneraI(^1 rector, ^88 May 5, ©"Mortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW Body was_r in (State whether cremated, buried, scored, etaTjP5^ (Cemetecs^-or crematory) Signature J (Sexton or person In charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). .„ i si <0VEE,f^r s'-ej-*. THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION ’ THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION BURIAL—TRANSIT PERMIT MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 BURIAL—TRANSIT PERMIT Full name of deceased Cause of death no. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 THEDA M - V - WILT — Date of death 12-7-19.88— _____ CEREBRAL VASCULAR ACCIDENT Place of death OTTAWA WRIGHT TWP^-------------- Race (County) (Township or village or city) ■ Method of disposal WOODLAND MF.MORTAT, PARK BUR TAT. (Whether burial, cremation, storage, etc.) | County APPROVED FOR CREMATION Sex F.E. Age—86 WHITE (Cemetery or crematory) State BARRY Signature of Medical Examiner MICH Date - —19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given ta WREN FUNERAL HOME Address HASTINGS, MI (Funeral director or person acting as such) to dispose of body of said deceased. Date Signature (Check one: Registrar, DEC* 9 19^§— Funeral Director. *gf Mortuary Science Licensee) • CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW C (Sexton or person in charge) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). ,0VEBI B*26 5/M �THIS PERMIT MUST ACCOMPANY REMAINS TO DESTINATION No----------------------------- BURIAL—TRANSIT PERMIT Full name of debased MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 GALEN S. MCCLELLAND ’ Data nf death 5-7- Cause of death RESPIRATORY FAILURE Place of death -HASTINGS TWP. BARRY , WHITE Spy M AgeJ7£_ (Township or village or city) (County) Method of disposal Rare oq WOODLAND MEMORIAL PARK BURIAL (Whether burial, cremation, storage, etc.) APPROVED FOR CREMATION (Cemetery or crematory) BARRY [County State—MICH . Date Signature of Medical Examiner ----19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given tn WREN FUNERAL HOME Addraaa HASTINGS, MICH (Funeral director or person acting as such) / to dispose of body of said de^easg^. Signature-------------------- nah> (Check one: O Registrar, MAY 9 o Funeral Director, (AMortuary Science Licensee) CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW j 0 Body was. . . (State whether cremated, buried, stored^tcV^ (Cemetejw oArematory) . (Sexton or person in charge) This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton). I b.m 5« , (OVER) //a >> / -y Z? , -s / 3 J �BURIAL—TRANSIT PERMIT No. MICHIGAN DEPARTMENT OF PUBLIC HEALTH Full name of deceased------~ 7" Cause of death placeofd,,th-■. JFA'TQfi/ Method of disposal—■Z2^g- —----------- UJUI-rP ~M RaceWHj^Tc^— Sex/7 Su/^F 7f~ Age2fa__ H . g buritb < < * ' APPROVED FOR CREMATION • ——— 1 _____________ Date Signature of Medical Examiner.---------------- -------- -------- - 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is hereby given to-j?§?4^ Z—*—& f*(Fi IZj----- — Address / 7 . SiZS (Funeral director or person actins as such) to dispose ofbody of saiddeceased. (Check one: Funeral Director, Registrar, o f _ ------- Signature , Mortuary Science Licen CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW This permit must be endorsed by the sexton for by the funeral director or Mortuary Science licensee where there is no sexton), BURIAL—TRANSIT PERMIT No MICHIGAN DEPARTMENT OF PUBLIC HEALTH Act 368 of 1978 and Act 299 of 1980 Full name of deceased ^7*3 CA £ p _ pate of deathA/^y Cause of death. 1 F*/ £ Place of death Method of disposal --- 13-VRJ.A L- (Whether burial, cremation, storage, etc^ Signature of Medical Examiner IdJUfTg Age /4 Sex/4 (Cemetery or crema^oy) rFjRk< State-?? z _____________________________________Date zy 1 19 A certificate of death having been filed as required by the laws or regulations of this state, permission is *<1 Ct! X hereby given to. o to dispose of body of saijtjeceased* o n r^l , [County- APPROVED FQR CREMATION Rare 1 (Funeral director or person acting as such) SignatureJ ** (Check one: Registrar, MX z Funeral Director, JQ Mortuary Science Llcen&£) Ma/ 19: co P X fc X CA « P- Body was. V) This permit must be endorsed by the sexton (or by the funeral director or Mortuary Science licensee where there is no sexton). E . CEMETERY OR CREMATORY AUTHORITY SHALL FILL OUT SPACE BELOW CUJ / F . in_ (1 (State whether cremated, burled, stored, eterj^ —> //O | (Cemeteryrematory) 8 X_____ HPVfc* Signature ' (OVER)^y B*26 5/84 (Sexton or person in charge) 10^ � Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Death Records Description An account of the resource Documents in this collection were scanned from hardcopies held in the Hastings Public Library's Michigan Room collection. There may be duplicative entries within sub-collections. All information was provided from external sources. HPL cannot guarantee the authenticity of any specific data point. Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Burial Transit Permits - 1980s Subject The topic of the resource MI.BarryCounty.DeathRecords Description An account of the resource Burial Transit Permits (Papers permitting the transit of deceased persons). All material was sourced from hardcopies held in the Hastings Public Library's Michigan Room collection. HPL cannot ensure the authenticity of any specific data point. Users should validate their research and cross-reference available information. Type The nature or genre of the resource text Format The file format, physical medium, or dimensions of the resource PDF