Hannah Myrtle TaylorIq
FOR INET RUCTIONS SEE MC i AND W',:?0 N
wnt�utun (nw. rry�) I,o.marry wn�r�:W1
A
In Washington state, cremation constitutes final disposition. This
COPY of the Burial - Transit Permit is for your records only. The
ORIGINAL is on file with the S.W. Washington Health District,
2000 Pt. Vancouver Way, Vancouver, WA 98663-3505.
M+d6e L1at
2. 5E%(IA /F)
3. DEATH DATE (W. Dw. YO
1. NAl€ Fret
HA14NAH MYRTLE TAILOR
Female
26 July 1995
A. AGE LAST MATH -5, UDR 1 YEAg 6. UNDER t my
7. &'RMDATE(VA DW, Yr) 6. &RTHPJ�GEP'_OEDEM EVEfl tO WUNTY p' DEATH
(CM. 6'.e4ea 7jre Courcry) IH US. ARMED FORDEG7
(y') U05 UTS I
91 1
(Y -IN-) NO Cowlitz
Dee.25,1903 Blair, Nebraska 11
11. CITY, TONN OR LOCAT1040F DEATH
12 PACE OF DEATH-MROX FOR PLACE THEN GIVEADDR— NSTIlUiI04 NAW- 17 DV0!U NGWIAST
1.01474E 20INTPM1POTT 30 EYBU RVID TPT4 4010SP. 06 N'AHOYE ,O 0TF,9I PUCE 16YEARS?VY /NO
Longview
Cowlitz Care Center No
14. MARTAL6TATU5-A'anod,
16. SURVMNG 6POUSE IH+'Ie,B+a maJsn rema)
16. SOCIAL SCURRY NO.
1T' oEaDFty-N Ore p canP'a�dj
I— K—d, Vldo.+ad,
D--(S
Ebmenery,5«mdary IU 121 C,e (1-4at»)
Widowed
Clarence Taylor (Dec.j
506 56 0022
Tenth
�.
a2 RUflV�LFREMATIOY
RF AL, OTHFO (6p�Ty)
Cr'emation
u DATE (Nb.Day. Yr)
27 JUL 1995
34, CDVETERY/CREIMTORY�NME
Park Hill Crematorium
36. LO:ATI04-G1TY(TOYM,STATE
Vaaaouver, Washington
36 nMEMI IXRECTO,I S'GW_Na
/..%
]7. NAME OF FPG�Litt
3fl PDDflE:SOFFPGILi
P.O. Box12734
X 0,
Heritage Heritage Cremat6minSociety
Portland, Oregon 97222
THIS BURIAL PC-RMIT MUST ACCO IVAMV 111'r-MAIHS TO DESTIMATIGM
A CERTIFICATE OF DEATH HAVING BEEN FILED AS REQUIRED BY THE LAWS OF THE STATE OF
WASHINGTON, PERMISSION IS HEREBY GIVEN TO DISPOSE OF THE BODY AS STATED ABOVE.
Cowlitz County Health Department
1516 Hudson P. O. Boa 458
Longview, Waslun on 98632-7296
..
REGISTRARADDRF.S27 740'
1
REGISTRAR SGNA''11
GATE 51GNED (Mo.; Day, Yeat)
X x JUL
4m
CEMETERY OR CREMATORY %HALL FILL OUT SPACE BELOW
cremated July 28, 1995 in Park Hill Cretnatory
Body was on
a
(Ru FIRED OR CREMATED) (IAO., DAY, YEAR) /� OR CREMATORY)
ice:
((CEMETERY
Vancouver, Washington
Place Signature
(SEXTON OR PERSON IN CHARGE)
See Other side
by the where interment is made (or by the funeral director where there is no sexton).
This permit must be endorsed sexton
Return within 10 days to the registrar of the district in which the cemetery is located.
FOR INET RUCTIONS SEE MC i AND W',:?0 N
wnt�utun (nw. rry�) I,o.marry wn�r�:W1
A
In Washington state, cremation constitutes final disposition. This
COPY of the Burial - Transit Permit is for your records only. The
ORIGINAL is on file with the S.W. Washington Health District,
2000 Pt. Vancouver Way, Vancouver, WA 98663-3505.
X310
as E NN CREMATION 33 CWT
� Vry a' OF,
uVanocuveWasbIO::ATION-1G`Y(TOWN, ST ATE ington
eaton jUL 1995 Park _11 C�em or
R_INER' D:HECTOR.GNANRE 22734
lnt:696nSocietv Portland, Oregon 97222Z
x Heritage Cre�
THIS MUPUAL PERTAIT -MUST IM -MAINS TODEMSTINATIO
N
A CERTIFICAT E OF DEATH HAVING BEEN FILED AS REQUIRED BY THE !LAWS OF THE STATE OF
E.
WASHINGTON. PERMISSION IS HEREBY GIVEN TO DISPOSE OF THE BODY AS STATED ABOV
y Health Dernrrtrnent
1516
P. G. Box 458
Lot Lwie
REGISTRAR ADD'K,25
REGISTRAR SIIGN&DATE SIGNED (Me. Day, Year)
9
x
Body was
Place
CEMETERY OR CREMATORY $HALL FILL OUT SPACZ BELOW
crertted on July 28, 1995 in Park Hill Crematory
1BURIED OR CREMATED) (MO, DAY, YE1,R) (CEMETERY OR CREMATORY)
Vancouver, RTashin_gton
S;gnalure
OR PERSON IN CHARGE)
See Gth'ar side
This permit MUs' be endorsed by the sexton where interment is made (or b,v the funeral director vAere, them ;s no sexton).
return within 10 days to the registrar of the district , in whicF the ceTnetery is located.
TO, IN6TRUCTiGN6 SEF H _ -C
DOHli (Ra 7RI) V1r1YDSHlEa)
A
In Washington state, cremation constitutes final disposition. Tjh
COPY of the Burial - Transit Permit is for your records only.
ORIGINAL is on file with the S.W. Washington Health Distric
2000 Ft. Vancouver Way, Vancouver, WA 98663-3505.
Lesl
iy TAYLOR
RTLE
2. (M In, 1, DEATH DATE (k,Day. Yr)
male 26 july 1995
1 YEA,
6, UNDER I �y
9. `,A3 DECEDENT -ER !a -,N-OF —TI
T.
Fa C-1) IN US ARMED ROF'Fa'
DAY cy') 1-1CAPS
H00RS MINS
(ON, Sale ar 29^
Dec.25,1903 JMair, tlebraska (Y -/N.) NO Cowlitz
V_ 91
.
6MOWNG IN LAST
11 9 CEOFDEA`IHIX FOR PI -ACE HE" -11F ADO- OR 'NMIM10N Hl iJE Ila 15 YEARS? I— I No)
<O HMP. C7Z N� SOME 5C 0, 4F FiZE
Lon -view
1 0 HOME 2 0 IN TRAh.IORT 30 EMS. RlIjDII PTN
Care Center Fo
A1err¢N, Wda«cd.
----Nevar
(Spec tt��
(1112) COTep- (1 -4 11
Clarence T a-lor (Dec.)
Xllenth
i506 5
as E NN CREMATION 33 CWT
� Vry a' OF,
uVanocuveWasbIO::ATION-1G`Y(TOWN, ST ATE ington
eaton jUL 1995 Park _11 C�em or
R_INER' D:HECTOR.GNANRE 22734
lnt:696nSocietv Portland, Oregon 97222Z
x Heritage Cre�
THIS MUPUAL PERTAIT -MUST IM -MAINS TODEMSTINATIO
N
A CERTIFICAT E OF DEATH HAVING BEEN FILED AS REQUIRED BY THE !LAWS OF THE STATE OF
E.
WASHINGTON. PERMISSION IS HEREBY GIVEN TO DISPOSE OF THE BODY AS STATED ABOV
y Health Dernrrtrnent
1516
P. G. Box 458
Lot Lwie
REGISTRAR ADD'K,25
REGISTRAR SIIGN&DATE SIGNED (Me. Day, Year)
9
x
Body was
Place
CEMETERY OR CREMATORY $HALL FILL OUT SPACZ BELOW
crertted on July 28, 1995 in Park Hill Crematory
1BURIED OR CREMATED) (MO, DAY, YE1,R) (CEMETERY OR CREMATORY)
Vancouver, RTashin_gton
S;gnalure
OR PERSON IN CHARGE)
See Gth'ar side
This permit MUs' be endorsed by the sexton where interment is made (or b,v the funeral director vAere, them ;s no sexton).
return within 10 days to the registrar of the district , in whicF the ceTnetery is located.
TO, IN6TRUCTiGN6 SEF H _ -C
DOHli (Ra 7RI) V1r1YDSHlEa)
A
In Washington state, cremation constitutes final disposition. Tjh
COPY of the Burial - Transit Permit is for your records only.
ORIGINAL is on file with the S.W. Washington Health Distric
2000 Ft. Vancouver Way, Vancouver, WA 98663-3505.