Trautwein, Catherine TURN OF QUEE9�5BURY
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director
Name � // /1/ � Rhb k.l l Case sip
Date of Crematicn /'�)-- / — :T<7
Time Cremation Started
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Time Cremation Completed �J
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Remarks :
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TOWN OF DUEENSBURY �
PINE VIEW CEMETERY v
a
CREMATORIUM
Quaker Road, Queensbury, New York 12804
Phone (518) Crematorium 745-4477 or if no answer
Cemetery 745-4476
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 :
Catherine Trautwein Female
(Name ) (Sex)
Green Manisons, Chestertown, N.Y. 12817
(Street ) (City) (State) ( Zip Code )
who died on 26 day of Nov. 19 98
at Glens Falls Hospital, Glens Falls, N.Y. 12801
(Place) (Address)
Name and address of nearest living relative or name of person
authorizing cremation :
DWI nJ 7 u7wt--i�v , /�� ?�� �l��, G.fZ/Znu Wu2�
(Name ) (Address)
Relationship to the deceased
Nave of Funeral Home—Alexander-Baker Funeral Home
IMPORTANT:
I represent that to the best of ray knowledge, the deceased X-X4(XX)OX(
has no pacemaker in his or her body. (Circle One)
I 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 , defenc
and save harmless Pine View Crematorium from any and all claims
and demands for loss or damages which may be made against there tD
reason of or connected with the cremation of said remains as
dir whether such claims or demands are or are not wholl ,
roundles false or fraudulent .
(Witness ) (Address)
(Signature of Relative or Legal Rep. and Address)
Signed on this date : Nov. 27, 1998