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Russell Buton WoodardIOWA DEPARTMENT OF PUBLIC HEALTH °`T BURIAL TRANSIT PERMIT NAME OF DECEASED Russell Burton Woodard DATE OF DEATH May 23, 2004 DEATH COMMUNICABLE YES PLACE OF DEATH CITYORTOWN Jefferson TOWNSHIP (IF KNOWN) COUNTY Greene STATE Iowa BURIAL REMOVAL CREMATION [::] OTHER: E PLACE OF DISPOSITION CEMETERY CREMATORY CITY OR VILLAGE COUNTY STATE Blair Cemetery Blair Greene Iowa FULL NAME PERMIT ISSUED Hastings Funeral Home ADDRESS CITY STATE TO: 403 North Elm Jefferson Iowa SIGNATURE A CERTIFICATE OF DEATH MUST BE FILED IN ACCORDANCE WITH IOWA CODE CHAPTER 144. PERMISSISON IS HEREBY GIVEN TO DISPOSE OFT IS BODY. SIGNATUR LE Funeral Director PERMIT ISSUED ADDRESS 403 North E l m BY: CITY Jefferson STATE Iowa DATE ISSUED May 25, 2004 NOTE: A BURIAL TRANSIT PERMIT IS NOT ISSUED FOR EVERY DEATH, ONLY UNDER THE PROVISION OF IOWA CODE CHAPTER 144 SECTION 144.32. BURIAL TRANSIT PERMIT 144.32 If a person other than a funeral director assumes custody of a dead body or fetus, the person shall secure a burial - transit permit. To be valid, the burial -transit permit must be issued by the county medical examiner, a funeral director, or the county registrar of the county where the certificate of death or fetal death was filed. The permit shall be obtained prior to the removal of the dead body or fetus from the place of death and the permit shall accompany the dead body or fetus to the place of final disposition. To transfer a dead body or fetus outside of this state, the funeral director who first assumes custody of the dead body or fetus shall obtain a burial -transit permit prior to the tlransfer. The permit shall accompany the dead body or fetus to the place of final disposition. A dead body or fetus brought into this state for final disposition shall be accompanied by a burial -transit permit under the law of the state in which the death occured. 588-0002 Rev. 10/93 CPL -09750