Lindquist, Carl TOWN OF QUEEN5B219�y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director/,7A
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Date of Crematicn !iL !z�'7/'"( /
Time Cremation Started
Time Cremation Completed �t 'I-I l(O N
Type of Container
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TOWN OF QUEENSBURY
PINE VIEW CEMETERY
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:
Carl Louis Lindquist Male
(Name) (Sex)
Main Street North Creek New York 12853
(Street) (City) (State) (Zip Code)
who died on the 23rd day of August 1999
at the Glens Falls Hospital Glens Falls, New York
(Place) (Address)
'! Name and address of nearest living relative or name of person
authorizing cremation:
Arlene Blanchard P.O. Box 667; Indian Lake, New York 12842
(Name) (Address)
Relationship to the deceased Half-Sister
Name of Funeral Home Alexander Funeral Home
IMPORTANT:
I resent that to the best of my knowledge, the deceased AODEW
Eas n 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, 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
direc , ether such claims or demands are or are not wholly
gro dless false or fraudulent.
. A exander 3809 Main Street, Warrensburg, NY 12885
(Witness) (Address )
6, 'stt�"a't4 -
( Signature of Relative or Legal Rep. and Address )
Signed on this date: August 24, 1999