Abbott, Fred 4
rrO
OF QUEE9�(
YI �
EW CEMFTtRY AND
' R ROAD, CREMATORIUM
QtlEENSBURY' NEW YORK 12804
(518) 745.4476 (518) 745.4.477
Fame
Funeral Director
Gate Of Cremation Case. 5-7�- L
Time Cremation Started
Time Cremation
Completed
Type of Container
Remarks s T S
M = q: `(o r.
VP
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TOWN Op (,)UE-l-.W3BUi?Y
PINE,VIEW CEMETERY
Yx
GPEMATOFUUM
Quaker Road Qtjeensbury, ?dew York
'7454477 (H no answer)
Phone (518) CVP--f)at0dtJn1
Cemetery 745-4476
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-'eS Pine View GrematollUm in ac.cordarice will-, and subject
he UtIclf-sr,signed requestS and authorizes
its RQ and lry I ulMns to crernale the remains 01`
AM�
(SEX)
i(NAME)
t6,A
t711`1 CODE)
(CITY)
day of
whd djed all
att' JMgu t
(ADORE
(PLACE)
-10rizing ,rnatlon�
N�We i Ond address of nearest living relative ()t person autl cro 12-o 6-r
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C
e)d .................. ......
ReAnship to deceSs
NY
Fjjf)eraj Home c
IMP(.'tRTANT knowledge, the deceased tiffi-, pac;vn*)akPr in his or her
�,:ent qlat Io J.l-IE! hest of MY
I R C L E N E)
-etnaos Urizaflo n to fur the the� I
amly that I have thr-4 fli(i ()owe"and aufl' nains. that any arrangPeerscmal POSSeSSIM15 crarnationof
have either Peen)
I to djr6ct the cjtSPOCibon at the VeMatfIld rel ;avp any and all harm whicleh BAS Pir's be View
,ree to protect, defend al f,
r9moked or may Oe destroyed an as MandF, 1()r loss or d ld�-Images RMY We
Mematorimn from (71aedg and dp as directed, wl,jethpr
on ()f or Qonneoted with the crernatic-111
a ,e ()I, fraudulent.
gainst tilem by reason not Wholly grWndle9s, falF
or demands afe OF are
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C}15Pi"USIT1ON oF CREMATED REMAIN
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1 eroby`direct. Piny; View Crematorium to disBuse of ihr; rremateci rr rrrair7.s as follows:
f ail to , s
{ tl�er art,ange.rr!nntS✓ lakease
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1f1prakveri alion of cremated re;rnains is requested, check here
4 i
POLICIES, RtJILrs AND REcyur.aTtOry
1 1 i"1e reinatorium will be open fnr crernations 5 mays a wee!< 7TO AM 3.30 P M. Monday-
Frid�,y. No Holidays or Sundays, arrangerYtents carp tie mach. foi iaturday. 're-arrangemetits
by telephone for acceptance of rernams is r,err�s.7ary
2 . Pine iView C�rernak)rirrrn is fasted err tl,e grounds of the P'M Vi�;w Gnmetery C�uake r i�aad,
1,own of atleensbury
3 An ��%�I.horizt�tion for crcan7ation property signed by It'(1) ne to arrange for"the cremation of the
arest next.of kin or other authorized
r person staling that they do have the pc,vler and authority
rernaIris and to direct the dispositicnr3 of the cren'!ated r��mdins, that. any personal possessions
Ihave+,either been rer�novc�d or m9y be destroye,,J and agrr.e to protect., defend and save
ha
nn{Pss i'ine View C.;rematarium frurn any and ail clai►ns and demands for loss or damages
Iwhich may be. Made against the;iri by 1-3I anon of Or r.;onrrer.,tc:d with i:irr� r.:rerriation of said
rerrrajns and /csr disrsc�s;ition of sait� rF�rnains as directed, whether sur:h r,iaims or,demands are,
Dr.art not wholly groundless, false or fraudulent, "f"his autilr.>rizat.ion in addition to a regular
burial pnr-mii: musi a.cCoMparsy the remains
4. All re mains must he encased in a cac,kc,t c r suitable alternrate coni:airter. Caskets and
r;ontainers rnusi I)e of cnmhustibk- rnatc ripfj. f i> >fyr()fiosm of. plastic; containers is will he
acr,.ep�ted
5.I The (1uestion relative to c::Rrdiac, Pacemakers must be answer+d on the, authorization to
(( Cremate fora) before, the rernains Vvill lae ac;ce.pted
G.1 I.lreln �a other arrangerne!nts <.�re inadr� Ihs c.rr_vn tPd Will I'ae marled via Registered
U. !S. tvlail within three days of cre r7-iation to the funeral hc,rme handling the service. There wllt
be a $25.00 charge for this Service,
C ..m<�tie,rs;7. AdministrationCostsandf2ec.r�rding I ee Aduii $3C)0.00 Children (age 13 months to
1". years) y15().00 Infants (t:i.ikfbcarr7 iCa IJ nionihs) $ (l(:} ()(?
A ddii:ieariai $50.00 charge fears (.icarre after 3:00 P (�A. Monclay through Friday,
C Iernatiaiis done on Saturdays vvill l)p ;;l,argt ri ii,re additional $1-01' 00.
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