Maire M. Briggsfo'D
READ CAREFULLY
• It is unlawful for any person in charge of a burial place or crematory to permit burial or other disposition of a dead human
body or fetus until a final disposition permit has been issued.
• A final disposition permit maybe issued only upon registration of a death certificate.
• A final disposition permit is required for any type of disposition of a dead human body or fetus.
• This permit maybe Used for transporting by common carrier.
• All permits must be endorsed by the sexton, recorded in the sexton's register, and forwarded within five days of disposition
to the local registrar or designee.
This final disposition permit, when completed and bearing the required signature, constitutes authority for burial, interment,
cremation, removal from the state, or other authorized disposition of the deceased named below, in accordance with Section
25-2-111 C.R.S. 1982. This permit must accompany the remains to their destination.
Name of Decedent Marie M. BRIGGS
Date of Death November 30, 2007
Sex F Age 89 Date of Birth Jan. 21 1918 Place of Death Aurora Arapahoe
City County
Name of Funeral Establishment FAIRMOUNT MORTUARY
Address of Funeral Establishment 430 SOUTH QUEBEC STREET DENVER COLORADO 80247
Type of Disposition Removal
Place Blair Cemetery Blair NE
Cemetery or Crematory City State
I have examined the completed death certificate for the decedent named above, and authorize final disposition of the re-
mains. (To be signed by the office designated or established pursuant to Section 25-2-103 C.R.S. 1982 in the county where
the deat Wired.)
P DEPUTY REGISTRAR
Or Signature Title
TRI Cnl1NTY HEALTH 7000 E. BELLEVIEW #301 GREENWOOD VILLAGE, CO 80111 December 4, 2007
Address Date
Items below are to be completed by the cemetery or crematory official. Where there is no full-time person in charge, the funeral
director may sign as sexton. This form must then be forwarded within five days of disposition to the local registrar or designee.
/2 7 07 �_ c
Type of Disposition /' /�� L Date � � In Lot � Block �� Bastian
Place 4 t l >� .3-14,14 e,r
ry ortory City State
-arSignature Title Date
AUTHORITY FOR FINAL DISPOSITION
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
Colorado Depaztmenl
of Public Health
and Environment
READ CAREFULLY
• It is unlawful for any person in charge of a burial place or crematory to permit burial or other disposition of a dead human
body or fetus until a final disposition permit has been issued.
• A final disposition permit maybe issued only upon registration of a death certificate.
• A final disposition permit is required for any type of disposition of a dead human body or fetus.
• This permit maybe Used for transporting by common carrier.
• All permits must be endorsed by the sexton, recorded in the sexton's register, and forwarded within five days of disposition
to the local registrar or designee.
This final disposition permit, when completed and bearing the required signature, constitutes authority for burial, interment,
cremation, removal from the state, or other authorized disposition of the deceased named below, in accordance with Section
25-2-111 C.R.S. 1982. This permit must accompany the remains to their destination.
Name of Decedent Marie M. BRIGGS
Date of Death November 30, 2007
Sex F Age 89 Date of Birth Jan. 21 1918 Place of Death Aurora Arapahoe
City County
Name of Funeral Establishment FAIRMOUNT MORTUARY
Address of Funeral Establishment 430 SOUTH QUEBEC STREET DENVER COLORADO 80247
Type of Disposition Removal
Place Blair Cemetery Blair NE
Cemetery or Crematory City State
I have examined the completed death certificate for the decedent named above, and authorize final disposition of the re-
mains. (To be signed by the office designated or established pursuant to Section 25-2-103 C.R.S. 1982 in the county where
the deat Wired.)
P DEPUTY REGISTRAR
Or Signature Title
TRI Cnl1NTY HEALTH 7000 E. BELLEVIEW #301 GREENWOOD VILLAGE, CO 80111 December 4, 2007
Address Date
Items below are to be completed by the cemetery or crematory official. Where there is no full-time person in charge, the funeral
director may sign as sexton. This form must then be forwarded within five days of disposition to the local registrar or designee.
/2 7 07 �_ c
Type of Disposition /' /�� L Date � � In Lot � Block �� Bastian
Place 4 t l >� .3-14,14 e,r
ry ortory City State
-arSignature Title Date