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Disposition PermitRECEIVED DISPOSITION PERMIT FEB 1 8 2011 CITY OF CHANHASSEN DECEDENT'S NAME WILLIAM ROBERT BURKE DECEDENT'S ALIAS WILLIAM ROBERT ALLISON SEX MALE DATE OF BIRTH / AGE FEBRUARY 02, 1948 / 63 YEARS DATE OF DEATH FEBRUARY 11, 2011 PLACE OF DEATH 2108 PEARSON PARKWAY BROOKLYN PARK, MINNESOTA HENNEPIN FUNERAL DIRECTOR M2152 FREDERICK C SOMAN FUNERAL HOME 0954 ALBIN FUNERAL CHAPEL, INC. 6855 ROWLAND ROAD EDEN PRAIRIE, MINNESOTA 55344 PLACE OF DISPOSITION CHANHASSEN PIONEER CEMETERY 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. Steve Elkins State Registrar Authorized Disposition Occurred on: Signature of Crematory or Cemetery Official: (type or print name of crematory or cemetery official)