Anoe, Hilton i
TOWN OF Q UEENSB UR Y
Pint Virtu Cemetery and Crentntorinnt
21 Quaker Road, Qtreenshtrry, NY. 72804.5902
(518) 745.4476
huP://w\vn (518) 745.4477
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Funeral Director:
Name of Deceased: '
Case Number: Z I
Date of Cremation:
Z ZU�c�
Retort:
Time Cremation Started: ; Ip
Time Cremation Completed: '_ 1 c?
Type of Container: LI s�
Remarks:
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CAL 3"• � ��'�
Houle Of Natural Benuty ... A COVII Plnre to 'Live -
� 217
Town of Queensberry
Pine View Cemetery and Crelr akxtum
21 Quaker Road,Queensbury, New York, 12804
Cemetery Office: (518)745-4476, Crerriatorium: (518)745-4477 '
Audxxbm*m to Cremate
The undersigned raquests and atom n toes Pine View Crernetarium,In amordence with and subject to Its Rules and Regulations to
cremate the remains of
Hilton James Anoe M
(Name) (Sex)
193 Benn Hebon NY 12832-
(SI3190t) (City) (Swe) (Z1p tee)
who died on dayd 05/09/2008 20_
at Glens Falls Hospital Glens Falls NY
(Plane) (Address)
Name=4 address d so me Ruing releO e or Rama of peiaon audXwtcrng cremation:
Syndonna Anoe 193 Benn Road , Hebron
(Name) (Address)
to910Wife
Name d Funwal Home Carleton Funeral Home, Inc.
IMPORTANT:
I represent that to the bed of my kxWedge,the deaeased(has) peoemreker,de4lbrtator,battery,battery peck,power
cell,redloective implant or raaoscOve desire In his or her body.(Crde one)
I OW*fiat I have fed power end aufiortmtion to anange for the creuneq X of the remake and to direct the dWpoattion of fie
cremated remake,fiat any personal poseewim have either been removed or maybe deaddoyed,and agree to protect,defend and
save honnleaa Pike View Cramteeorium from arty and aN dams and dem or ds fw bw or damages~may be made against lhsrrn
by reeaon d or con rood wNh 1M cremation of said wick as dhw%Kin whether such damns ar darrrarrds are or are not wholy
fain or
68 Main Street, Hudson Falls, NY
{VYlbtess) (Address)
193 Benn Road, He b✓Or
wviav"and Address of Reft6w or L%#RepresersetIve)
Signed on this date: I o 2 006
Dispwkkm of Cremated Remains
I hereby direct Pine View Crematorium to dispose of the cremated remains as foNowra:.
Mail to
Other arronipffner"-Please spew.
If puiverketion of Cremated remains is requested,dm&here XX
Rsvisian:April 18,2007