Straight, Patricia OF
_/ QUEEN,50UTVT EV' CEMZTERY AND17 CREM
�'�KER ROAD, QUELNSBURY ATORTUM
(S 18) 74$.4.476 NEW YORK 12804
(518) 74$'.4..4.77
Funeral Director
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Dante Of Cremation
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Time Cremation Started
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Time Cremation
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Type of Container
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Pine
Town of Queensbury
21 Qtt er Nrm%vRoa a rm
Conetuy nd Cn8W ium
Qom.New York 12W4
CMVIOry Of xx 518-745-4476.CremaWritim 518-745-4477
Audwdza*m W CreMaW
Thecr hate and audwrim Pine View Qom,in accordance wfh am 10 ks RL"s and Regtdat OM to
Patricia E. Straight Female
(Name) (SWO
251 River Street Warrensburg NY 12885
(S0e4 (CRY) (Stele) Op Code)
whodiedon _Saturday, 6th day of nprpmhpr 2D 08
at Glens Fall . Hogp; ral Glens Falls , NY
(Mace) (Ass)
Now slid address of newt M8 Mla M or name of person aulhortzing pmnatim
Mindy Straight
(Name) (per)
Rely wort to the deceased daughter
NameofPunwwHome Alexander-Baker Funeral Home
IMPORTANT:
I represent that to the hest of my k nowieckm the deceased(his)oriites pacemdw.deflbdb Qr or�outer operated
device in his or her body. (Code One) ���J
1 oenity that 1 have fop power and suthortzation to mange for the aeandon of the remains and to direct the d WoertWn of the
cremated remalhs,that ary persortai Possessions have either been removed or may be destroyed,and agree 10 prated.defend and
save his Pine View CrenWorkm from any and alt chime and demands for Was or demeges which may be made egei W them
by reason of connected e fsd as decd such lef s orderands me or ae not ut"y
���L �, CjIlCrfc S�u
(Swaaae Alddress of or Legal R ye)
Sow on Uft aate: Cm
tisposWon of Cremated Remains
I hereby dire«Pine View Creowto lum to dispose of the cremated remeirts as tonows:
funeral .home will pick up.
Other anangwnents-Please spew.
If p*ertaMon of cremated remains a requested,check here X
Revision:49bt�
/8 f)M 07
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Policies, Rules a
1. Pine View is tooted on the grounds of Pine View Cemetery.The
Monday through Friday from 7:90arn to 3:30pm. Prior telephone
` of remains are necessary. Pi'ea rigemerrts cire.
•'ate' nu
necessary cremations.
2. A " 'signed by to nearest next of kin is rosary stating
that they and su ority to arrange for tt cremation the remains
and to di of the cremated remains,that'any personal possessiOnS
have elther,, or may be destroyed and agree to protect,defend and save
harmless metery and Crematorium from any and all claims and demands
for loss of ich may be made against thaM bey reason of or connected with
-- -- the crem remains and/or disposition of said remains as directed,whether
such claims are not whoily`oMkI Less;false orfraudutent.This authorization in
addition to a r I permit must accompany the remains-
3. All remains m a casket or suitable alternate container. Caskets and containers
containers will be accepted.
serial. No foam or plastic-c�nta ocept
must be of� e ma styro p ,
4. Cardiac defibrillators or other battery operated devices must be removed
before. . -be accepted.
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5. :Cremation$ pied within three woridng days.92 hours)of receipt of the
Buciat Autha�rization to Cremate Foi t:.-The cremated:remains will
he ri ei Uf.5..1 1 wt ttiree:days of n to home
handling t sses. other arcangernents are made.Tfiere will ei a#25 Wcharge
for this ce.
6. Cremation, Costs and Recording Fees:
Adult i $3ge;o 3SO.
Children ( 1 the to 12 years)' $1aA:68• l�a-
Infants (stil '>i months) OM[- /30.
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