Oehler, Philip OF QUEENSB`Zl
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director P\ LJ--- 1�
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ate Of Cremation
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. :T.e Cremation Completed
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remarks
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Town of Queensbury
Pine View Cemetery and Crematorium
21 Quaker Road,Queensbury, New York, 12804
Cemetery Office:(518)745-4476, Crematorium: (518)745-4477
Authorization to Cremate
The undersigned requests and authorizes Pine View Crematorium.in accordance with and
cremate the remains of to its Rotes and Regulations to
Philip Oehler Male
{�e> (Sex)
21 King St. , Warrensburg, NY
(Street) (City) (state) (Zip Code)
who died an 17 th �yof June 06
20
at 21 King St . , Warrensburg, NY 12885
(Place) (Address)
Name and address of nearest living retatim or name of person authorizing cremation:
Lou Ann Rose, 21 King St. , Warrensburg, N
{Name} (Address)
Relationship to the deceased Daughter
Name of Funeral Home Alexander-Baker Funeral Home
IMPORTANT:
I reWesent 11kit to the best of my knowledge,the deceased(has) (has no) maker,defibrillator or any other battery operated
device in his or her body- {Circle One}
I certifjr that I have full power and authorization to arrange for the carnation of the remains and to direct the disposition of the
cremated remains,ttred any personsl possessions have either been removed or may be destroyed,artd agree to txacect,defend and
saw hartmle I�irte Yrew Cremalown from any and all claims and dernaods for loss or damages wtuch may be made against them
by reason of or connected with the cremation a f said remains as directed,whether such claims or demands are or are not wholly
groundless,false or fraudulem A
Warrensburg
ness) (Address)
King St . , Warrensburg, NY
(Signatwe and Address of Relative or t_egal Representative)
Signed on this date.
Disposition of Cremated Remains
I hereby direct Pine View crematorium to dispose of the cremated remains as follows:
Mail to
Other arrangements-Please specify: R t n to Alexander Funeral Home.,
If pulverization of cremated remains is requested,check here
Revision:January 1,2005
Policies, Rules and Regulations
1. Pine View Crematorium is located on the grounds of Pine View Cemetery.The
crematorium operates Monday through Friday from 7:00am to 3:30pm. Prior telephone
arrangements for the acceptance of remains are necessary.Prearrangements are
necessary for Saturday cremations.
2. A "Authorization for Cremation"signed by the nearest next of kin is necessary stating
that they do have the power and authority 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 Vlew Cemetery and Crematorium from any and all claims and demands
for loss of damages which may be made against them by reason of or connected with
the cremation of said remains andlor disposition of said remains as directed,whether
such claims are, or are not wholly groundless, false or fraudulent This author Untion in
addition to a regular burial permit must accompany the remains.
3. All remains must be in a casket or suitable alternate container.Caskets and containers
must be of a combustible material. No styrofoam or plastic containers will be accepted.
4. Cardiac pacemakers,defibrillators or other battery operated devices must be removed
before any remains will be accepted.
5. Cremations will be completed within three working days(721oixs)of receipt of the
Burial Transmit Permit and Authorization to Cremate Form.The cremated remains will
be mailed via Registered U. S. Mail within three days of cremation to the funeral home
handling the service unless other arrangements are made.Thera wilt be a$30.00 d�arge
for this service.
6. Cremation,Administration Costs and Recording Fees:
Adult $325 00
Children (age 13 months to 12 years) $175.00
Infants (stillborn to 12onths) $125.00
Overtime Cremations(Weekdays) $45Q.00
Saturday Cremations $450.00