Kaliski, Erna TQrV N OF QUEEN,5BUr
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director_ C�
Case
-'a c e Of 'Cremation
=re Cremation Started AA,
' iTe Cremation Completed
e of C o n t a i n e r ('Jr1 ) \l-- `'r
remarks
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Jan 19 04 04: 44p Carol 201 -816-8720 p. l
J1{19I2004 15:20 518--696--2743 BREWER FUNERAL PAGE . 02 .;
Town of Queenabury
Pine View Cemetery
&
Crematorium
Quokor Reed,Queensbury, Now York 12604
phone(518)CMn810M M11 745.4477(If no anVASr)
Cemetery 745-4476
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AUTHORIZATION TO CREMATE
71ro undsnip ied and Pine View t ronuAoriu m in ecvwdwom wills and subod
to ift Rules and uiations cremate the remains of,
Erna renne Kaliski Female
Narrw sw
12946
Stoat C 4 Seca Zip
1
wft died on day of 20 0 4
at Glens Falls
piece i Addmn
Naas and addm I Of nee living relative or ram of person au#wrszing cremation
Carol GaROF LO, 24 Delmar Ave. , Cress Rill, NJ 07626
Reladionship t0 do doughtjr
Neme of Furw0 I Imm BREWER FUNERAL HOME,INC.
IMPORTANT
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of 916 0"wwwd d ' Irma fny paeesaiam hew slhw been rww- a mW bs dwV&M wd a9"
to pn4,d,de1.+land hwwhn V wr Grn+roft"from w►y wa ar cteiem e�,e a.nw+d.xr roe.a d.nep e a wn►
pee wMeh m,s roads ' t Own m mm ar a can voW w!h she aa"Now si said a I"* aw d�.cted,wl"M ed,
vAw wiw anon clams dwrwrds or so not wh*amunti aa,hbe or inudubmt
i Address
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(SIG OF RE OR LEGAL REPRESENTITIVE)
signed on this `�