Gahan, John Jr. ' Ai
p F QUEE9�S3U2r
WE YIE`W CEMETERY AND CRE
QUAKER ROAD QUEENS$ MATORIU
URY� NEW PORK 12804
(518) 745.4476 (518) 745-4477
Funeral Director
Name lr (A� a�
Case#
Dace , �7�1
Of Cremation
Tame Cremation Started
l " US
Time Cremation Completed 3 ` It,
12i
Type of Container II /` J//�
ar:1p'Sr� ��,wl��lY
Remarks C
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21 thubw Road.CANN asbury,New York,12804
'esaOWy ORIM'.(518)745.4476.Cretrtll3 Uwk .(518)745-"77
Au#xw1 &m to Cremate
T>,e urtdetslgrtad ragtl0ets tigtf�i(Attor res>krtrte lflew Ctemelorptn.br a�oofdertoe vft aid aubjed to its Rules and Regul tom to
crefrtatettte rents
John J. Gahan Male
(Nam) (sex)
Apt 28 D�,. Peac!�ful VaI4-ey Ridge Rd. , North-creek, NY
O (titht) (Sm4a) (Zip ?
who died on 1 .th'..; deyd April 08
at Apt 28D ''leceful Valley Ride; lid, North Creek
(Place) ; ; (Address)
Name and address of nttwgd 8vinp reledve.or name of pwwo aWtorkina cmmatkwL
Sorg a Gahan Apt. 28D.PPeaceful Valley Ridge Rd. , North Creek
(NiffRetatlor*Np to the de6e1849d°.: W if e
NamGdFunerat" Alexander Funeral' Home Inc.
IMPORTANT:
I represent that to itr beet,f>f.my b �0.the deoaeaed OM)or(has no)pmwnd w,deftNatar,battery,battery per �,p
cell,radlosciWe knpli oriadioedlve dstrioe in his or her body-(Cirde One)
cw*that 1 haw U power w d atittorF odm to sa pe for the cmmodw of ate P ii iwdto&wuwftMskionotft
cxecnated remekts,Naet. ,�sQael po�veetorts have ear 1 a rerrtolrad Ar tttiey to destroyed,end agree to proted,defend and
save harttrlaes Pktd 0ronrt any and a0 ar�d�lemapds fior bss or drrtgl g- each mey be made against them
by reason of « crwNedcn of said ranmirtsas directed.vrhedw suds clsYrts or demands are or are not wIvoy
7X
77.
.,, (Address)
( and of Robtive or t eta!Repa�e)
SW.d on this date: April 14, 2008
UWposidort of O wneted Ransns
I hereby diced Pine View Crematorium to dispose of the cxemeted remains as follows:
Mall to
oUwaTangwnentq_ apvy. Funeral home will pick up
If pulvenzation of cremated remains is requested,check here R
Revision:April 18,2007
. j
Policies, Rules and Regulations
1. Pine View Crematorium is located on#w m ands of pine View Cemetery.The
crematorium oQ9t '► Ft ►.fitlrrt 7. 3:30prn. Prior telephone
a -tortise ecoepmrroe of reineirts are are
necessary for overtime or Saturday c remabons.
2. A `Authorizeibion to Crw:naW form signed by the nearest next of kin Is necessary stating
that they do have the power and authority to arrange for the cremation of the remains
and to direct the disposition of the crested raemakxs that any personal possessions
have either been removed or may be dasrgyetl end egms to prgteck defend aad save
harmless pine View Cmatery,artd GlremWortwm from any and all clainns and demands
for toss of damages wttich maybe made t Them py reason of or connected with-
the cremation of said remains andfor disposidon of said remem as directed,whether
such damns are,or are not wholly q=vftM tge orUauduktrtt.This ault"tation in
addition to a regular burial permit must accompany the remains.
3. All remains must be in a casks or sukable akenvw corriakw. CaWWW and containers
must be of a combtwMe nalieriat.No atoutxkn Or plandc COF&Bkwswill be accepted.
4. Any cardiac pe0am mine 5,defib Ulalam may.bWery pwK per Cell, radioactive
Implant or=dioecOe devias must be f@aW +edIt+ottt cite body before any remains will be
accepted.
5• becoenpfe�tedwiNnirrlyt ae4 Ot s)of rapt of the
P 1 Jim Au gfgC " to d' mated remains:will
be mailed VW WOA46d U.S.MOUNWt ft"doysof CfiamOM to the ftuterai home
handling the service unless other attangetttertts an made,Them will be a$30.00 charge
for this service.
6. Cremation,Administratbn Cost&ar1d.%gQgrft
Adult
children (ape 13 monft to 12 years) $18MW
Infants (stillborn to 12 months) $130AO
overtime Cremations(Weekdays) $48.do
Saturday Cremations $480.00