Fehlner, Edward E:
OF QUEEN5BUP
PINE VIEW CEMETERY AND CREMATORIUM v
QUAKER ROAD, QUEENSBURY, NEW YORK 128C4
(518) 745-4476 (518) 745-4477
Funeral Director
Name A_ Iw�E�p �� f r P
Case#
Date Of Cremation
Time Cremation Started I 3U
Time Cremation Completed I!Uo
Type of Container
iS C
Remarks
Jul 6
(Z'-------------
ID
3�1
Town of Queen 6i"
Pine View Cemetefy and Cfematotium
21 Quaker Road,Queensbury, New York, 12804
Cemetery O(ftce:(518)745.4476,Crematorium:(518)745-4477
-AWvortcmf :to Gremaft
The undersigned rogtreets and attttwitms Pins View Owmatun,in aocorderme with and WNW to ks Rtfes and Re sorts to
cxerrrete the renm*w of
�D2 D MCI
is (ter) (stab) (zip Code)
who dbd on 9 TN day of 41117-. zoo,?
st'&OK • &c'al.41, SA—4yLjnL L i9r�C', N� /?s93
fimmoo-mol, mew vF-nmmw arst reilt!s or rye or .pemr.aAKwtdg usrr. rt:
-rt)A/tee) ��L'N�.�/rn, le-4 ,jc��'tT,%
PAIsmaddPtoaredeoemsed SOS
IMPMANT:
I repesertt atet to are best of my btowbdgm.are deceased(has) as aoenteiter,dobriibom or any over battery operated
dwft to his or her body. (Ckb One)
I aeNfy do I hens ful power and auator nom to aruw for ate amrneaort of the remewts and to dlrerat ate disposition of are
aem Elm d rorrteitte,stet ary personal posmeeeiorts trmtre Am been removed or mmy be deahoyed.and sores top deOwW and
-------- --- -
�8 Pfrt�1Aesl�rksrefa!te+e!as�e ae�et ne rleime� ��� .__.sr .�—
pow wric� ilFCiL'r'wr +,�yaN17�47��6Q�01N �QQsef
grorrdbes a or*audttbrtt. 2310 Saranac Ave.
Lake Placid NY 12946
( )
J�A"QZ
anFdeAWwo G f O Lo 0 7
DbposVJon of
I hereby dWW Pine View AnerrteRoritrrrt to dispose of ate creamW remains es foNows:
MaNto
Other artangernaft-Please spedfy ,�:^ 11C!/LL iUcUP nld4a If p Awizedon of arentmbd remains Is mWested,do&two
5
Policies, Rules and Regulations
1. Pine View Crematorium located on the grounds of Pine View Cemetery.Cremaatorium throug rktay from 7:ppsm to 3• The
__aff o Tii .�.fob!•the
i y �,{�. l�jof _ . Prior telephone
i�'3 W*9W. a .�atio T. si a -_ .��aasasLH sZa a
2. A "Authorization for Cremation' -
that they do have� ��by�nearest�d of kin�necessary
��
and to direct the disposition �uth�ority to avenge for the���remains
have--ow twgw camated r�rnlnw
airlS,ttn 8ny peel s
harmless Pine View Cernet ' "'-'—W Pr defend and save.
for loss of oY and Crematorium from arty and all claims and demands
h may be made againstagainst them by reason of or connected with
2ech"clanime'soenrof,saidrye or are not wholly disposition of said remains as directed,whether
addition to a regular burial ly groundless,f8lse or fraudule IL This authorization in
permit must accompany the remains.
3. All vervains must be in a casket or suitable alternate container.Gaskets and containers
must be of a combustible material. No styrofoam orp contakars.�be accepted.
4. Cardiac pacemakers,defibrillators or other
betlery before any remains will be accepted. ° t�' vi'cas must be removed
5. Cremations wit be completed within three working days(72 hours)of receipt of the
Burial Transmit Permit and�iorization to Cremate Form.The
be mailed via Registered U.S.Mail within three wed remains will
handling the service unless other errs of cremation to the funeral home
for this service. are made.There be a0.00 charge
6. Cremation.Administration Costs and Recording Fees:
Adult $325.00
Children (age 13 months to 1)years) $175.00
Infants (stillborn to 12 months $125.00
Overtime Cremations(Wraekctayssr .(
�uurtay Cremations
$450.00