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Aldous, Ernest JOU111b O GCeeili " . ritlE VIEW CEMETERY,,rid CREMATORIUM QUAKER ROAD, QUEENSOURY, NEW YORK 12801 (518) 798 4 72G (5I8) 793-9777 Funeral Dirictor /��j t1�me /T i �11�.FS� �.0 „�C�LJS Case No. UaLe of Cremation Tints Cremations Started W.,$-11,41 M f Time Crewition Completed ioV '1}*1p ot: Container �r9�'? U,C3O/9/J�1� eZ NO, C A4 S.C- O 7W-d= 01, Y ttcrr�i r.k s �/° /,/� t3lJ ,cif' ©/Sr/ �-�J�1 ZYo C4 o .0 Z?d 4I// - - -- TOWN OF QUEENSBURY PINE VIEW CEMETERY do CREMATORIUM Quaker Road, Queensbury, New York 12804 Phone (518) Crematorium 798-4726 or if no answer Cemetery 793-9777 AUTHORIZATION TO CREMATE The undersigned requests and authorizes Pine View Crematorium, in accordance with and subject to its Rules and Regulations to cremate the remains of: Ernest George Aldous Male Name Sex Apt . 10C, Earl Towers , Hudson Falls, NY 12839 Street City State Zip Code who died on March 15 , 1992 day of 19 at Glen F 1 Ho ' Place l 1 NY Address —— Name and address of nearest living relative or name of person authorizing cremation: Mrs . Althea Adlous Name Earl Address) NY Relationship to the deceased Wife Name of the funeral home Carleton Funeral Home Inc . IMPORTANT: I represent that to the best of my knowledge, the deceased has or as no acemaker in his or tier body. (CIRCLE ONE) 1 certify that I have the full power and authorization to arrange for the cremation of the remains and to direct the disposition of the cremated remains, that any personal possessions have either been removed or may be destroyed, and agree to protect, defend and save harmless Pine View Crematorium, from any and all claims and demands for loss or damages which may be made against them by reason of, or connected with the cremation of said remains as directed, whether such claims or demands are, or are not, wholly groundless, false or fraudulent. Witness 68 Main St . Signature o Relat ve or Legal Rep. Hudson-Falls , NY 12839 Apt . 10C, Earl Towers Address Hudson Falls , NY 12839 Address Signed on this (late March 15 , 1992