Albrecht, Joyce r'.Lu
"UN OF QUEEVBU9Zy
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director 4-ri t�
Name VC-14 Case#
Date Of Cremation
Time Cremation Started 2-
Time Cremation Completed
Type of Container 114,1
Remarks
CAA(A)V�0g.,
l ` ZO
TOWN OF QUEENSBURY
PINE VIEW CEMETERY
&
CREMATORIUM
�.* ORIUM
Quaker Road, Queensbury, New York 12804
{Phone (518) Crematorium 745-4477 or if no answer
Cemetery 745-4476
- AUTHORIZATION TO CREMATE
The undersigned requests aqd authorizes Pine View Crematorium, in accordance with
and subject to its Rules and Regulations to cremate the remains of:
Joyce Ann(Andrus)Albrecht Female
(Name) (Sex)
1010 Dix Ave. Hudson Falls,NY 12839-
(Street) (City) (State) (Zip Code)
io died on 15tn day of October, 2005
at Glens Falls Hospital Glens Falls,NY
(Place) (Address)
Name and address of nearest living relative or name of person authorizing cremations:
Dennis Albrecht 21 Kelly Ave. , Hudson Falls, NY 12839
(Name)• (Address)
Relationship to thcdeceased son
Home Carleton Funeral Home, Inc.
Namof Funeral
IMPORTAW:
I represent that to the best of my knowledge, the deceased has or A_no
pacemaker in his or her body. (Circle One)
I certify that I have the full power and authorization to arrange for the cremation
of the remains and to direct the disposition of the cremated remains, that any
personal possessions have either been removed or may be destroyed, and agree
to protect, defend and save harmless Pine View Crematorium from any and all
claims and demands for loss or damages which may be made against them
by reason of or connected with the cremation of said remains as directed,
whether such claims or demands are not wholly groundless, false or fraudulent.
L/VJ( 68 Main Street, Hudson Falls, NY 12839
(Witness) (Address)
K - � (X/ J_ Hudson Falls NY
(Signature of Relative or Legal Rep. and Address)
Signed on this date: Oct 16, 2005
' TOWN OF QUEENSBURY
CERTIFICATION OF CREMATION
PINE VIEW CEMETERY & CREMATORY
This certifies that the remains of: JOYCE ANN ALBRECHT
were cremated on OCTOBER 18 ,20 05 at the Pine View
(Month) (Day)
Crematorium, Queensbury, New York, and these are the cremated remains
of said body.
Date of Death OCTOBnn�ER , 15 ,20 05 Age 71
(CARLETON (Day)
Funeral Home Registered No.: 433
(Authorized ignature)