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Disposition PermitDISPOSITION PERMIT DECEDENTS NAME MARCIA KAY LONG DECEDENTS ALIAS MARCIA K. LONG SEX FEMALE DATE OF BIRTH /AGE NOVEMBER 02, 1950 / 55 YEARS DATE OF DEATH AUGUST 24, 2008 PLACE OF DEATH FAIRVIEW - SOUTHDALE HOSPITAL 6401 FRANCE AVE SOUTH EDINA, MINNESOTA HENNEPIN FUNERAL DIRECTOR M3058 WALLY GELECINSKYJ FUNERAL HOME 0914 HUBER FUNERAL HOME & CREMATION SERVICE 16394 GLORY LANE EDEN PRAIRIE, MINNESOTA 55344 PLACE OF DISPOSITION FAIRVIEW CREMATORY 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. X..4� ,k ' a Linda Loftus Acting State Registrar Authorized Disposition Occun*d on: Signature of Crematory or Cer*etery Official: (type or print name of crematory or cemetery official)