King, Erna 2�0 q+N OF QUEENSB U1 y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director N)6-j
Name ,C&d �����- Case # 7
Date of Cremation Cz iv2 — aL
Time Cremation Started 7f'c;zn lbi I
Time Cremation Completed 7,QO o6fm ,
Type of Container ?00:: dZD /,I-)
Remarks :
TOWN OF QUEENSBURY
' PIN> VIEW CEMETERY
CREMATORIUM Q
Quaker Road, Queensbury, New York 12804 D
Phone (518)Crematorium. 745-4477 ;4 no answer) j
Cemetery 745-4476
i
AUTHORIZATION TO CREMATE
The undersigned requests and authorizes Pine View Crematorium, in a.cordance with an� subject
to its Rules and Regulations to cremate they remains of j
ERNA M. KING "'
F I,
(SEX)
(NAME)
118 BIG BROOK RD, INDIAN LAKE IVY 12842
STREET; (CITY) (STATE) (Z1P CODE)
day of po .
_
I
AI.BANY MED. CTR. AI,BANY,NY
�L AGE; (ADDRESS)
a d acdress of nearest living relative or name of person authorizing mennatior. i
I
VIVAN J. KING is$ BIG BRD R I
i
at onsnp to deceased
HUSBAND
I I, H E
INC.
--fi—_--
- _ 0f Fo!'.eral 'Home
1
MPORTANT o emaker ir. is or �.r
r�. =n� 'nat to the best of my knowledge, the deceas d has �r nas n P"j}c-
_�-.r.v mat I nave the fLii power and authorization to arrangesoo l o r
nal possessions have eit erbeel
e,. the aapos bon of the cremated remat�oteci defend and save harmless Pine y per
Vie
e; o May be destroyed, and agree to p
from any an all claims and demand
c ematon of said remains as di ec ed or loss or damages wl"!c'r' may be n+�hether
-.21-st Inem oy reason of or connect e soundless, false or fraudulent.
_,a.:.;5 cemands are or are not wholly g
tt—NESSI (ADDRESS)
SItiATIJRE OF RELAT E QR LEGAL REP, AND Ail
DRESS)
G
�, ;~is Cate _�._