Linn, Janice OF1.1�L
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PINE VIER' CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY NEW PORK 12804
(518) 745-4476 (518) 745-4-477
Funeral Director
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Date Of Cremation (J ,,I b
Time Cremation Started b
Time Cremation Completed 1( .?c1
Type of Container
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Remarks
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Pkw Yip Cry and Cr errat dwn
21 Quaker Roan,Queensbtay,Now Yak, 12804
Cemetery OMcw-(518)745-4476,Cnefttat kww(5181745-4477
Aft to Crei<rfate
The uttdecSOVd rem tnsd SUMWttxsS PIM Yew CMKMIMI St4 M BOCCIdWeavft and 9A;ed to Its Rules and R to
cremate the remetins of
.Janice Linn Female
(Nam) (Sot)
Snurh lohnsgbu_r_ _ Rd. Warrensburg New York 12885
(Street) (fit) (Slaw) (Zip Code)
whodedon 24th dayet November 2D 07
at i1PDR Falls Hospital Glens Falls , NY 12801
(fie) v )
Name and address of nearest Hav relative or naim of person autharbmng cremawn:
Scott Volk So . Johnsburg Rd. Warrensburg, NY 12885
(Nanwe) (Address)
Re4etforisW to#se detaased husband
Nan-.eofFw,wwHome Alexander-Baker Funeral Home
IMPORTANT:
I repreeera that to the best of my kwwW^the deo cd(w)or$m no)pw&mww.dw&makw.may,bWWy per,pa*w
cell.tam)ective irnow t or ndbactive devil a in hie or her body-(undo 0.)
1 nertl#y that#ha�re pones aetd m arras tbrtlte moors titre rearm anti th dW no tlisisosaion of the
cremated.IMIUMi5,that WPOSSOSSIOrisromeawbears atr Y bedMwjetf,and agree t6 PiP.defend s-d
save Null Mcre w Clerrf oriuns from ww anti an and I nds tie im ar damages ends wW be made e p h si them
by or brie�r�ors ts�said�� sv�ds d�or dest�s are or ate not whol�r
gry
�—(VYWwS-- ) (Address)
(Side and Address of Relative or Legal Repngpentaitm)
Signed on this date: ^x),/L7
U"x)srion of Cwmeted!Remar►s
1 hereby&ad Pine View Crenwarkim to dispose of the cmmaW awnek s as toUows:
mauto Funeral Home will pick u
ottsex artangemestts-i�Idsase sped#y_
if puNertzatlon of aemated remains is den tad,do*two XXX
ReroWm-..Asti!18.2M7
Policies, Rules and Regulations
1. Pine View Crematorium is laded on the grounds of Pine View Cemetery.The
Crematorium operates Monday through Friday from 7.1)Own to 3:30pm. Prior telephone
arrangements for the acceptance,of renv*is are necessary.Preenangernents are
necessary for overtime or Saturday ems.
2. A "Authodeadw to CrernaW for rn signed by the rmerst next of kin is necessary stating
that tl"do have the power and 8Uftft to arrange for the cremation of the remains
and to direct the disposition of the cremated ram,#nj any Personal possessions
have either been removed or may ba deswayed and agree 10 pfflUCL defend and save
harmless Pine View Cemetery and Cr borlurn*CM airy and all claims and demands
fear toss of dames which mad be made agairM thdrn by IMOSbn of or connected with
the c region of said I-M-1 — of spid remakm as directed,wheiher
such dims are,or are not wholly grounifins,fad or taudulent.This audx izadon in
addition to a regular txrial pern*must accompany U-0 ram.
3. All remains must be in a casket or she ar>ele container.Caskets and corers
must be of a GumbustFale matedaL to stymfa ►or plc tx rs wM be acoeptsd.
4. Any cardiac pacenu*ms, I-fit M ,be".berry pack.paswer cell, radioactive
implam or radloaciive.device ming be removed ftm the body before any remains will be
accepted-
5- Cremebom will be=WeWd wMWw ftee wolung days(72 hours)of reaeV of the
Burial TrairoM Pernalt and Aug hori t to CrenMe Fit.The amnated r+enmins will
be mailed via Rem U.&Mal wWm thtM ftS of OUTWOM to the funeral home
harx#ling the service urflew GVw anrngeffmM are maft Thm will be a$30.W charge
for this service.
U. Cremation,AcirnWlstragw COM SIM ReoordhV F
Adult $330.W
cfilicmen (age 13 months to 12 yeas) $1MOO
Infants (stillborn to 12 rr ) $130.01)
Overtime Cremations(VYeltdays) $480.00
Saturday Cremations -00