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Burial PermitDISPOSITION PERMIT DECEDENT'S NAME JAMES LEO HOBAN DECEDENT'S ALIAS JIM HOBAN SEX MALE DATE OF BIRTH / AGE JUNg 17, 1'47 63 DATE OF DEATH MAY 2, 201:_ PLACE OF DEATH SHOREWOOD, MINNESOTA 55331 5525 MANITOU LANE FUNERAL DIRECTOR PAUL F_ HUBER FUNERAL HOME HUBER FUNERAL HOME EXCELSIOR, MINNESOTA PLACE OF DISPOSITION PIONEER CEMETERY (URN INTERMENT) CHANHASSEN, MINNESOTA According to Minnesota Statutes, section 149A.93, subdivision 3, section 144.221, and Minnesota Rules, part 4601.1500, the fact of death has been filed with the Office of the State Registrar. Linda Loftus Acting State Registrar Authorized Disposition Occurred on: Signature of Crematory or Cemetery Official: (type or print name of crematory or cemetery