O'Neil, Elizabeth • .f
OF QUEE9�5OU2r�y
PL'NE 'YIEW CEMETERY AND CREMATORIUM
QU"F.R ROAD, QUEENSBURY NEW YORK 12804
(518) 745-4-476 (518) 745--4-477
Funeral Director
Fame_
Case# (170
Date 0( Cremation Tp
Time Cremation Started
Il�vs ,yM
Tame Cremation Completed
1=UU PM
Type of Container ti,� {w 09 C
Remarks
1 14OVC-7
1Z:30�
Caujr � bof'�1
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Town of Queensbury
Pine View Cemetery and C remakidum
21 Quaker Road,Queensbury, New York, 12804
Cemetery Of k a: (518)745-4476, Crematorium: (518)7454477 '
Authorization to Cremate
The undersigned requests and autfwdm Pkre View Crematorium,In a000rdarioewkh OW Vubied to<ts Ruins and Regul IoM to
cremate the remeft of:
Elizabeth O'Neil
(Name) {Sex)
Il.�� eLL I �, n��✓� &An a
(Street) (City] (State) (Zip Code)
who died on day of
(13110m
) �1°0 ° (Ad )
NW"NW of 'd�' Ownefim
T ( ) )
Rele unship to the deCea9ed
Nu dFuendtim, Carleton Funeral Home, Inc.
IMPORTANT:
I repregent that to the best of+ny kawwk dg%the deceased(tm)ar no) maker,de�Abrtt OW,be",ba tlery Pam,tamer
cK rsdloeedve kwhir t or radoacttwe devios in his or her body.(
i cerWy that 1#rave U power and suawrb ation to emerge for the cremation of the r woft end to dkw the diepoeition of the
crenated nrmakts,60 arty pemorW posevedw s have sMhar been removed or maybe desbayed,and apron to profeet,defend and
gave hennbsa Pima View Cremetar m fiom arty end aN dakns and demands for toss or damages w dd maybe made agwat them
by reason tlrs cremation of said Nernakrs es dk eNed.whedw such doom tts or damands wine or ens not whoNy
68 Main Street, Hudson Falls, NY
of ReWwe or t eget RepresentdNe)
Signed on this date: j
Diepwkkm of CremeW min
(hereby direct Pkre View Crematorium to digpase of the cremated remebw se foNowir
Meal to
other arrangermwm-Piasee spew.
tf pAverbation of cremated rameims is requested,dreck here XX
Revs kwL ApFU 18,2W7