Corrigan, Robert �O OF QUEEN50UPry-
PINE VIEW CEMETERY AND CREMATORIUM
QUIZ ROAD, QLIEENS$ y. NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director CGrltfvh
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Case#. L�S�
Date Of Cremation
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Time Cremation Started p�
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Time Cremation Completed
Type of Container
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Remarks
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Tom of Qutury
Pine View Cei stymy and CYeffift um
21 Quaker Road,Queensbury, New York, 12804
Cemetery Office: (518)745-4476, Crematorium: (518)745-4477 '
Audmizatioe to Cremate
The undemsigrod(egneste and a d hod es Ph*View Ckeamlarlum,in aa000damoewlu,and st**d to its Rubs and Repubtiom to
cremate the remelts at
Robert J. Corrigan M
(Nome) {Seri
Blue Ridge North Hudson NY 12855-
(SVed) {City} (Stele) (ap Code)
vdho dkd on day d 10/19/2 0 0 7 2_
at Residence North Hudson NY
(Piece) (Address)
Name and eddrass of nearest Oft rdetivs or name Of pardon ahrltw b*V aemsOm
Susan Staton 866 Colusa Ave
(Na(W) {Acklress)
Reiahfomft to the Daughter
Nwmof kwwrWFkx, Carleton Funeral Home, Inc.
IMPORTANT: de
beat gjjL � ry���Y,�Y Ems,Power
sent the to fire of iagwbd�e,the oeaaed(has) rs
E reyma _
cell,radioscom bptent or raftective device in his or her body.(CErde one)
I oOr*that i have"power end authnmizetio end to dkW the diepoeitfon of dta
ci n wtv remains,that any personal p oeae cliotts have either been mamaved or malt be dee0+ayvd,end agora to prole!!.data and
save hartttbsa Pine View Crwal riutrh iom spy and 0 del i anti demands nor toes or damages vA dd may be We!+pained them
by r esso d or eonrrecied wNh the aameiion d said tematns es dnectsd,vdw dvm such cle>trrs or rim nherds are or eme not wttofy
grlm"or
68 Main Street, Hudson Falls, NY
(Addrmses}
Col a Ave
(5pne2tae of Relative w )
Sipped on Obis dace:
Disposition of Cmam td Renteft
I hereby dhW Ptae Vkw Crematorium to dspoae of the all. remains se fallows-
mal to
Other arrem>semmiemtes'Please specUy=
ff p hwft lion of Ownetod remains is meq ceded,do&here XX
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