Meade, Kenneth Jr. '7-n' rMN OF QUEEN,5BUP,,-Y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(5 18) 745-4476 (5 18) 745-4477
Funeral Director (, ora
Name �,.►n'(� N
` � �� r Case# (�
Date Of Cremation
�A'1. 1 -2
Time Cremation Started o Aft
Time Cremation Completed 12: G- y
Type of Container , G
r -��E sT c,+
Remarks
ovG 4;5G
iv, 70
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Town of Queetubury
Pine View Cernelcy and Crematorium
21 Quaker Road,Queensbury,Now Yodr,12MM
Cemetery Cam:(518)745-447 6.CmmWilum:(518)7 77
AutAori mlion ID Crengft
The under requem elycl a0mm Ftm View OmBOoMm rn aecafdaflM vft and stied to ft RtftS and RegutMns to
cremate"rertafns at
Kenneth J. Meade Jr. Male
(48") (sex)
Shoshonna Dr. , Crown Point, NY 12829
( ) (CkY) (State) (gyp Code)
who dial on 6 t h day of Jan 2Q 0 8
Moses Ludington Hos . , Ticonderoga, NY
ram) (AddcesB)
Narne and address of nearest Gvetg rele ive or rune of person au#xwizbV cremation:
Marie Montena, 55 Peaceful valley Rd. , North Creek, NY 12853
O O
Rewoonstup to ttre deceased c o u s i n
Namooffunwalirlome Alexander FH, Inc . , North River, NY
IMPORTAW:
t represent that to the best 01 9W knowiedgs.On deceased#6W Otas no)paoatnaker def xNaW,battery,t y peck.Power
cell,radioactive implant or tadoacfte device 6t his or her body_(Circle One)
i certify that 1 have*A also Rooms m d to OW ttte asposmon of"
c renm fed re V=any pow tt wee0w been mmed or we16edesboyyed,ad eqw to p1 a!act,defend and
save PSne VIOSv b m agr gad a9 cbb and forkm ar damages aMridt may be grade agehmewn
afar t vocromodancrasid inil as whel w such daises or demands are or are not wholly
.faFse
Warrensburg, NY
tom) ( )
Same a& above
(Souffiae arc!Address of Rel$t w or legal Repmser tmWe.)
Skpwd on this date: 1-8-0 8
DisposWon cf Cremated Res
I hereby dared Pine view C emuorlum to of eke cn m wd remains as follows:
man to
Qatar&mnWnem_please spew F H will pick up
if puiver¢atlon of cmmeled rernem is requested,check here X
RovJW.cn:4pt11 13,2007
Policies, Rules and Reguk&rts
Q ematcdum is located an Um orounds of Pim vow cemetery.The
c,rerwatowrn operates Wforday ttwouo Frifty ftm 71Xkwn to 3:30pm. Prior telephone
necessaq for ove0ime or Sahtirday crennavons
Eult=- bjtoarrw—W-fdr mematbn of the rermns
-nd to direct the disposition c4 t"is cr��a,
nave either been removed or may be deatoyed dz�
%40ors
;�4-w ar4 aqN,i;;a4flis ar4 dental-R,E
be
y b ran tat or f corinected wW-.
the crruriation cf seiid rerra=.G,
such claims are,or are rx)t wholly grCaundiess.%!so er f."wjdU:z1,rm Th:3 au� Mg
add.%.-r,to a rcgu!ar buna:ocanit must a=-.wa,-w
I All remains must be in a casket or s Me
a COI-T.UL Ubeb-le 1 uzieftel-N U- % Vcfweln Q p6-�, u Qmuab)w S Will be aLxxpwd.
0 b,"t tt-,ti now--� C)kA- 1 1 rA-d KnIA-di vf--
ur.-z-J!uaCVw-8 dswtce aTuat be ffiffwe� ran*js will be
acceotea.
thfC<;w%widw days M hours)of receiat of the
Z Pe.4;z: na -..-m;itp-ndkX=A=mtDC=Iitakr LTnecremated reffeim will
be.rwWl Via Reg-igered U. S. ?"z"
C!eMa"ent. Adm. mrratum COS,�S rTtj RCCMC"
UNI&I-9n (age 13 mr-w#-f-ts to 12
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0 ver fi I IC a s. (AA e,vk&ay s)