Warrington, Leona l O`RIN OF QUEE9�5BUT�y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURy. NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director
\ame 0A N/nr(1A)-6►. Case#. t/07
Date Of Cremation Se 00"7
Time Cremation Started
Time Cremation Completed 1'.10Av(1
Type of Container kr� w.� C�Qy,�u�� !ST C 5
Remarks
JAZU T,20 4M Mav 1)0 Ail
rr0L 2o
View Cemetery TOWM of OueWebtuy
and m
21 ( t-Road.Owedttdmy.Now YwK 12804
Cmakuy (518)745.4476.CmnaWft :(5181745 4477
ID
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VMMW MAjOd toff Rules 0-d RepAollons to
aemew the rsmatrrs of
Leona I. Warrington Female
(Nw*) (sac?
Box 143, Peaceful Valley Rd. , North Creek, NY 12853
(Street) (CRY) (State) (Zip Code)
who died on 1.8 t h day of A u R _ 2p 07
w Glens Falls Hospital
(mi) ( .$)
Name and address of ne eg fiwv relative or mama of person aAtarlzuv cremation:
<—'—VC0N c , a-OUkel) (57t &--4CeF,aL (A" &A, AlbW--/Cec6rN�f
(Nsme) ( )
Relalonsidp b ttte deceesed Daughter
Naffmof wmwl-lom8 FH, Warrensburg, NY
IMPORTANT:
I reprewt tint to the best of my knowb Oor,the no)pa0egrta W deft#MM.be ty,bogy plc.pow
cell,ra*mctive knOwt or ve&nctive dmk a In tSs or her body_(t;.rude Che)
lcerWygolherieUpowwwdmgwftWmtDwaqpfwtw ,a1rt of the rt o and to the cispos$ion of the
cxIX=aed)ems,that any pt f palm J, homeOwbOMMMMSOFMYtBdMMUISMOdWfttDpr c lect.defers erM
same he radess Cradrt:Wrkw from wdq and aI ddms add dadaadtd 1 for bee or damages tedtidt may be rrtede igif litilmn
by reason of wth lim croon of said navab as wed,stealer such ck t n or denim am or are not wholly
f be or
Warrensburg, NY
i.. ) (Aftem)
Same as- above
(SWMUOa and Relative a tagpi ire tivs)
Skp*4 on this date• 19 Sep. 07
uisposition of cremated Remalre
i hereby direct Pine bear C emat Wum to dispose of the cserrretad remains as follows:
Mad to
omeranvVernem_ r- FH will pick up
If Wiveri som of cremated re nem is mgaeated,chi"two X
Rervfsiott:Aud 19,2007
Policies, Rules and Regulations
1. Pine View Crematorium Is located on the grounds of Pine View Cemetery.The
crematorium operates Monday through Friday from 7.1)0arn to 3:30pm. Prior telephone
arrangements for the acceptwxe of nmuins are necessary.Pi esn angemerds am
necessary for overtime or Sahxday moons
2. A 'AmOuxteation to Creme'forrn signed by the nearmt rid of kin is necessary staring
that they do have the power and authority to arrange for the cremation of the remains
and to direct the disposition of the cremated rams,dud any personal possessions
have either been rem or may be desbuyed and agree to pfolect,defend and save
haffniess Dine View Cemetery and�m gate arty and all dram and demands
nary be
for hm of damages which n ettOde bgr reason of or corn edged Wth
the c rerna*n of saki rrerrea and/or dWpmftm of-saft tanwires as mod,whedter
such dims are,or are not wholly groundless,false or taudulem This authorization in
addition to a regular bum pea M must accompany the rem.
3. All remains must be in a casks or sine allemale cmeakw.CaskM and corgainem
must be of a GombustltAe m0WWL Nostjmb=or we be acoepted.
4. Any �deft abv s.battay.battery ice.power cell, radloactive
iml font or radioec hve.devvioe must be renew ftm the body before any remains will be
accepted.
5. Cremations vN be axn~watts*me wwWq days(72 hps)of of the
Bra'iat Tra ra tt Perry andAuthwkm M frame Forst.The�r will
be mailed via Registered U.S.Man t t of Cott ID the*moral home
handling the service unless cum—, 81 FE".QVIMM 2M MSKUX Them try be a$30.W clue ge
for this service.
b. Cremation,Athmnlarstion Caps and Recort"Fes.
Adult $3W.W
GNIdren (age 13 rnonft to 12 yeas) $18MOT
Infants (fin to 12 months) $13tD.f
Overtime Cremations(Wddkfts) $480.00
Saturday Cremations _oo