Phillips, Richard TOWN OFQUEEN,5BU-r�y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745.4477
�J Funeral Director G j,, 4\-"-" K
-f�A-1�r) I- > /� f7 Case,: A
gate Uf 'Cremation
Cremation Started
' ime Cremation Completed
'> ^.e of Container lzo 2 N
;e-.-narks
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D15pC7StT1ON OF CFtENkA"l'EC7 Rf:.MAifd
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I er byrrtireet Fine View Cremr�torirrm to dispose of the cremated rcarnains as follow;;
M B Clark�_Inc
ail to �._..__..___,_..-w,.,......_.,..._...T.w,.___..__.. —
�- _...._.� 27— Sa"ranac�Ave , LakeNPlacid, �NY 1294 �
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( itiPr ar!angernents-please spec:ify:._.__._.,_._.._ _ � __-
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If pulverilation of c rer•nated rernains is rectu�astc�d, check hem.xx
POLICIES, R![jI-ES AND RrC7ULA fIONS
day
The .1lCrematotium will be apes for crerrr�rti�.arrs 5�can be Made �) Saturday 0Pi-ar ang me.nts
Friday. Colo Holidays or Sundays, rarrangElment.7 can i
by telephone for acceptance of remains ig r'rer..rasysary
2 . Pine IiVievo C:rerneatmium is located on the grounds (-J the p,irjr:�Vif:w Gearrrtery, Quaker Road,
Town of Queensbury.
o-her au
zed
.3 An a ltl7arizratian for r..ren7atihave the rx wer-andllar.ithorityato arra next
ngc;�for,the cremat on of the
person slating ti'lat they do a
rrrrra�rrs anti to direct the dispGsitiar3 of i1lr; rr'en'rated rs�mainsa, t#'��rt any personal possessions
either been rernoved or may he de ntrayec;l anti agree to prC} na defence and save
havei
h rrn ess fine View Crematorium from any and all claims and cic rr�ands for loss or damages
which may be rrrade against.there by rr�-a son of nr connect.c:d with the cre(,natiori of said
4 rerrrajns and Icsr dis;3os.ttic�n of said mmains as direr_ted, whether such claims or demands are,.
r r ar i not wholly groundiPSS, false i,1r frar.sdulent. "Phis authc.�rizat.ir�n in addition to a regular
burial ;�ermil. must accornpariy the, remains;.
4. All r�c�`rnains mra>f. be c�nc;7sed in acac;kr.t ar suitable r�lternatc cr.}r+.tairrC�r. C;;askets and
r..ont�rirrrrs rr�ust be
rcnmbr.�t�tiblc r �atclrr,!. No 5tyrafoam or plastic, containcs►'s will be
Iam-ei led.
5.� The yr,restion relative to c:r�rdiar, pact�rnakers must be aras;wrec:i on the, authorization to
1k creinke form hwore thE,
l bP, mailed via
C.' I..lr�P49 oil'usr arrangements ,f e ITma +�n era the�frtneral!trorr e rti aincfiing he service.
gThere rRegistered
t.1:S, [Nail within t1'rree days c
be a $25.00 charge for this service.
msatic}ire. Adrninis,tration
Costs and ilec.ording Fee Adulf $300 00 Cl-fiidren (age 13 Mouths to
f'Tyears)'$150-00 Infants 1s:;t.illborn i.o 12 rnonihr) $100 00
a flc0il iv}c}ncl Y tCrough Friday,
deltiar a! ° { OQ chargef
C ¢,r�rretioij5 dune on Saturdays will I>F Ch,argc:;d the addiii�:}rah! f,!iC! OU.
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Phone
-n accordance with nnd subject
View (�re,T)atofiui
January
iranac
!Char�yne Phil
M B Clark, Inc. , 27 Saranac Ave- F Lake -Placid,
jlyip(�RTANT l.-1aCerrl8i<,er in his or her
o;,ertjl-,v that I have tllr-' f"(1 Powel- -nains q)at any personai possessions have eith(�r been
.) from any wid all cl@iffls and der jrrjages which may be made
onnc�cted with the crernation
w »p' "~^^ ~' reason whuUVQ[oUnd|86�. f�sB � nx
Orauuvu.
8�dh!C�|ms0/de��Pndsapg nut
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26 Cherry St. , Lake Placid, NY 12946
( Ol/ll/04
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