Sandra Lea HawthorneCOLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
AUTHORITY FOR FINAL DISPOSITION
This final disposition permit, when completely filled -out 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 HAWTHORNE Sandra Lea
Gender F Age 53 DateofBirth Jan. 15,1947
Date of Death June 18, 2000
Place ofDeath Arvada Jefferson
City
Name of Funeral Establishment Morgan Mortuary Inc.
Address of Funeral Establishment 6370 Union Street Arvada, CO. 80004
County
Type of Disposition Removal From State 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 remains. (To be signed by the office designated or
established pursuant to Section 25-2-103 C.R.S. 1982 in the county where the death occurred, or if such an office does not exist in the county where the death occurred, by the
coroner or the coroner's designate.)
Marc D . Smith Deputy Registrar Jefferson County Vital Records - Dakota Building
p t g 800 Jefferson County Parkway, Suite 1300 June 21 , 2000
Signature Title Golden CO 80401 303-271-6450 FAX 303-271-6451 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.
Body was
Place
Date
In Lot Block Section
Signature Title Date