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Mosier, Lillian
r TOWN OF QUEENSBURY Pint View Cemetery and Cremntorinm 21 Qunker Rond, Queensbury, NY. 12804.5902 (518) 745.4476 (518) 745.4477 hicp itwww.queensbury net Funeral Director: Name of Deceased: k� �L 1 `A N A©S / 175- (Z Case Number: 1 Date of Cremation: J J�- 2-V 0 5/ Retort:Time Cremation Cremation Started: 'Q 2 Time Cremation Completed: Type of Container: Remarks: Rlf Homy of NntitrnI Benuty ... A Good Plnie to Live ' 03/13/2005 17:01 510-793-3641 SINGLETCN/SLILLIVAN PA&E 02 TOWN OF OUEENSWRY l/ I PINE VIEW CEMETERY&CREMAMMUM PhOm(610)CrGmatorhtQUWW m no of �x8�4 Cerrwtery 746-4470 AUTI ORIZATION TO CREMATE The UndsraigW M4umto 4nd auk Ph*View Cramator(trcn, in Acc 4tnoe with and subod to i!s Rules and Regulations to Cremate the rernslns of: (Shea) (Cky) *ft died on day of ekdaag at 6 (P ) � )((AMdldbrvm o y r Name and address Of nearest rBWOM or name of person Auft;rft orsmg&n: y (AddMs) Re sup to Me decDofted .S NaTo of Fun"Noms- MkU ml &Potter Im"TA T; `wry NY 12804 I'Wnbs t that bD the beat of my knowAvdps,"dsosaasd has o�P�In his or her body. (Clyde one) 1 ce'* the I have the►uN PO*W and W totfaation to arrange For ft cramatlon of the mnghs and to duet the dmpoWm of the caommed mmaft, Noel any Personal Posseselons have sow bw removed IV may be ftWoyed,and MOM!o Proleot, defend and savtr harmless PiM View rir8rnatOrllitlf frx7fT+ any and sH cadre and demands for lose of deing®ss which may bs roads them by ninon of or whogyconr%l gro with the oremONon Of used tsmakq is directed,wh*w such cams or s am or are not wholly gnaurtdisss, a'trltudulant. rasa .z- v ter AV (;"ore Of Relative or Legal Rep,and address)} lee Slgr on this data: