Battey, Donald 1 !
TOy� F QU
EN,SB U
PINE VIEW CEMETERY AN
QUAKER ROAD, UEFNSBURY CREMATORIUM
Q NEW YORK 12804
(5 18) 745-4476 (5 18) 745-4477
Na m e
Funeral Director
Un�+�f� `1110 r
� Case# 3
Date Of Cremation (- ZZ.. d
Time Cremation Started
Y,Gb
Time Cremation Completed
Type of Container C,Ar Pew� ce�w� IS
Remarks T G 5
"h
rdo
TOwn of Queensbury
Pine View Chary and Cmnat wum
21 Quaker Road,Query.t4ew York,12&X
Cor ek4y Qfftoe;(515)74-54476.Cr+gtnaWjjum:(518)745,4477
Auf uftseori Ila C.Mr»e
The UFKW IWW MQLNM etc attlitt bMs RN Wit.M 8ccmftnMvft and to irs Rubs and R to
Ownste the rmrtahn ot:
Donald John Battey Male
( ) (sex)
PO Box 147 Pottersville NY 12860
(Strelet) (may) (state) gip Code)
„hodWon 15th aayaf January 2008
at Stratton VA Hospital , 113 Holland Ave , Albany
(fie) (Address)
Name and address of nearest ovbv relative or warns of pemn aLaku ft c won:
Astrid Battey PO Box 147 , Pottersville NY 12860
tom) wife (Address)
RO4 Onshtp to the deceased
Nam of Funeral Home Alexander-Baker Funeral Home
INiPORrAW.
i mepremd that to the best of try ftww M the deceased(has)or OM no)pacemaker.defihrMator,bafty,battery pact,power
cell,radloecfive implant or nxkm cdn device in his or her body-(t:,isde One)
I Cen fy that I have tug power�wort to a"*nW tar the csenta*0 Of 20 term attd tQ c rite dopoSfflon of the
`-mat e` '-mm- have emm tm=MWW Or aW to daWpysa and ages to protect.defend and
*ornanymWagde. and I I f riass er vlidt stay be made apehst ttrem
Wiz'W u + + of saki rr as dy 'pr,' wh~stchcWmordmmmftwooramrawhony
g7AHRR88s,feseorirrpr dent.
cue�Add�ss� - �I-egal fr�re)
Signed on this date.
LSposuion OF Cremated Remains
I hereby drect Pine View CrenvOurkm to of the rsenrraed remeft as Rglows.
mail to
Qther arranges_Ptease spur: Return to Funeral Home
If pinion of mwnated remains is requested,check here X
RwAslcn:"13,2DO7
Polices, Rules and Rem
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