Marie E. CleaverIOWA DEPARTMENT OF PUBLIC HEALTH
IZ
BURIAL TRANSIT PERMIT
NAME OF DECEASED Marie E. Cleaver
DATE OF DEATH October 2, 2009
DEATH COMMUNICABLE
NO
PLACE OF DEATH
CITY OR TOWN Missouri ValleFWNSHIP (IF KNOWN) COUNTY Harrison STATE Iowa
BURIAL
REMOVAL E::]
CREMATION
OTHER: E
PLACE OF DISPOSITION
CEMETERY
CREMATORY
CITY OR VILLAGE
COUNTY
STATE
Blair
Blair
Washington
Nebraska
FULL NAME
HENNESSEY AMAN
PERMIT
310 E. Huron
ISSUED
MISSOURI VALLEY,IA51555 7/ -
TO:
ADDRESS CITY STATE
310 E. Huron St. Missouri Valley Iowa
SIGNATURE
A CERTIFICATE OF DEATH MUST BE FILED IN ACCORDANCE WITH IOWA CODE CHAPTER 144. PERMISSISON
IS HEREBY GIVEN TO DISPOSE OF THIS BODY.
SIGNATURE TITLE , yr f
PERMIT
ISSUED
ADDRESS 310 E. Huron St.
BY:
CITY Missouri Valley STATE Iowa
DATE ISSUED October 5, 2009
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 tt,•ansfer. 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