Carr,Evelyn Funeral Dirictor /� pe l- S
Name o� /� _flLL _-�-Case Number -7*1-1Z --
Date of Cremation
Time Cremation Started 1_�.i o oZ
Time Cremation Completed
Type of container
Remarks
funitral fiEruICE A
44 North Main Street Rutland, Vermont 05701 (�
(802) 773-6252
Rutland,Vt. Wallingford,Vt.
x '
State of Vermont.
Examiner' s4 Permit to Cremate a Dead Human Body
Name, Evelyn Carr
Address East St. Wallingford, Vt.
Date of Death 3/24/88
Place of Death. East St. Wallingford, Vermont
Permission to Cremate tis Body At
Pine View Crematroy Glens Falls, NY 12801
( Name and address of Crematory)
Requested BY, Aldous Funeral Home
44 North Main Rutland, Vt. 05701
( Name and address of Funeral Director)
Vt. State F)D) # 19
Being Sufficiently informed as to the causes and
circumstances of the death of the aboved described
decedent, Permission is hereby granted to cremate
the body as requested.
date_,_ signed
Examin is Address --
O
, .
Aldous Funeral Service ii
44 No. Main Street
Rutland, Vt. 05701 773 6252
PINE VIEW CREMATORY. . . . . . . . . or
CREMATION ORDER Number
Vermont Cremation Service
J Bennington, Vermont
The undersigned hereby requests and authorizes Vermont Cremation Service in accordance with and
subject to its rules and regulations, to cremate the remains of:
Name Evelyn lozier Carr Sex female
East street Wallingford, VT
Residence
who died at
Her Residence, East street Wallingford, VT
(City) (Town) (State)
Date 3/24/88 19 Age 72
Check One:
❑ single ?9�married ❑ widowed ❑ divorced and certifies and represents that they have the right to
make such authorization, and agrees to hold Vermont Cremation Service harmless from any liability on
account of said authorization and cremation, and directs that the cremated remains are to be disposed of
in the manner prescribed on the reverse side of this order.
I Husband Authority to Sign 'r:�eez
(Relationship) 1 3/24/88
Date:
Street: east street
Wallingford, VT 05773
Date of Cremation: City: State:
(Funeral Director) Aldous Funeral Home
Main Street
Wallingford, VT
05773
No cremation shall take place until all fees have been paid.
SHIPPING INSTRUCTIONS
To: Vermont Cremation Service
I desire to have the crernains named on this order handled in the following manner:
Shipped to: Aldous Funeral Home
44 No. main street
Delivered to: Rutland, VT. 05701
Scattered by air
I hereby appoint you as my agent to act in my name as consignor, and authorize you
to sign my name to all papers in connection therewith.
It is fully understood that cremation has been fully completed at the time the
remains leave the office and the disposing as above directed is my act as person in
charge and at my risk. Vermont Cremation Service is acting s my a ent onl and
for my accommodation.
Signed
Dated