Loading...
Scott, Barbara Yr Tc 5IN 0 QU E E 23 U PINE NrIEW CEMETERY AND CREMATORtVM QUAKP-t ROAD, QIIEENS8lIRY JTW YORK 17804 (518) 745.4476 (518) 745'•4.477 Funeral Director 1 Fame Sr011 G r Jit Case # :aye 0 ( Cremation M a ova " e Cremation Started Te Cremation ComPleted lU -uo ' pe of Container Cti�choti.d 45- C remarks v— z 50 ALI— t1© oto Tom of Queensbury Pine View Cemetery and Cr+ematafium 21 Quaker Road,Queenebury, New York, 12804 Cemetery Office: (518)745-4476, Crematorium: (518)745-4477 Authorization to Cremate The understpned r Kpm is and audeortaea Pk*View Crometodum,In acmrderce with and subW to ks Rubs and Regulations to cmvwe the remains of Barbara E. (Ball) Scott F (Name) (Sex) 17 Moss Street Kingsbury NY 12839- Meet) (CRY) (SWA) (Zip Cam) echo died on 2 2 n d day d May 2007 20_ at St. Joseph's House of Grace Glens Falls NY (place) (Address) Name end address of rteareat 11*9 ralerhre Or Rants Of peraan authork&V aenradart: Mrs. Lorrie Britton 19 Marine Drive (►Jame) (Address) ReWora W t0 the deoaeeed Daughter NamedFuneralKno Carleton Funeral Home, Inc. IMPORTANT: deoeaaad{ ,deftNO Or, Y tom,Pms t represent the to the beat of my iaevwledge,tlw ties)C����e�peoe oW,radloecom tntpterti Or nmWx c We derrioa in his or hs body.{ I ow*that I tare tur paws and audxwbnt on to affwV*for the cren►ako d the renrakre end to dwect the dispowlan of the crarrrattrd rernairre,that arty peraorrtd poseeesbrte have eM1er been removad or maybe destroyed,and agree to pr—1 4 defend and am hamMeaa Pine View Cramelmt im from wV and al clef m and demands for lose or dsrriapes which may be made edektett lflam by reemn of or wnromd wkh die crivnedon of avid remains as dkeoted,whedter a xh c1a' a denraads are or ere nm w x ffy groundless,rabe or 68 Main Street, Hudson Falls, NY ) ( ) 19 Marine Drive (Signature end Aodmw of Reladrre or teal RepresertatMe) Signed on thb dm.* Dleposkbn d Cremated Remekts I hereby direct P1ne View Crernalortum to dbpoee of the cremated remake NO%%M'. Meal to Other arrwVements-Piesse epedfy: tf pAwrketion of Cremated remakes is wgr wkW,deeds have XX Re+rfsi=April 18,2007