Benway, Virginia TOWN OF QUEENSBURY
Pine View Cemetery and Crematorium
21 Quaker Road, Queenshury, NY. 12804-5902
(518) 745-4476 (518) 745.4477
http//wNv\v.queensbury.net
Funeral Director:- A
Name of Deceased: '✓ v `� 4 ti3
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Case Number: 2 15r y
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Date of Cremation:
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Time Cremation Started: O
Time Cremation Completed: /d �/ ,
Type of Container: r✓ � 1 ^�k!-JZ U �1/{ ��1�
Remarks:
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" Home of Nnturnl Benuty ... A Good PInie to Live "
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TOWN OF QUCLfQWHY
91.,qE VIEW CEMETERY&CREMATORIUM
Quaw Wad,Ousefte",New YOU,12804
Phone(515)rren**rWrn 746-4471 or w answer C*msimty 745-"16
AUTHORIZATION-D CREMATE
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