Howard, Alice OF
QU
EE So U r
PLNE V( \J
Eyv- CEMIMRY AND CREMATORIUM
'gtj'X F-t ROAD, QUEENSBURY, KBW YORK 12804
(518) 745.4476 (518) 745•4477
1 Funeral Director
Name /III arlC
Case#.
Date Of Cremati.on
Jar 7 �oo�
Time Cremation Started
I: io
Time Cremation Completed
Type of Container
�C' J i1 _
�JLLi�YY f pwvr q
remarks Zhp ( 5
UVt— L
A
Z'31J f t7
Lj6 M
# 16
J
Town of Queensbury
Pine View Cemetery and Crematodum
21 Quaker Road,Q,teerfmbury, New Yolk, 12804
Cemetery Office: (518)7454475, Crematorium: (518)745-4477 '
Au don to Cremate
The urW slgrced rertueats and maw ms Pk*View Orern0oriunt,in sa mrdwwe with rim u0ject to Its Ruias and R oans to
dsernete die rerWft(*
Alice E. Howard female
MOM) (SOX)
_Forf 11114 nn r'P Fort Edward, NY 12839
(Street) (CRY) ( ) (Wp Cam)
who died on 4th day of January 20 09
at Fort Hudson HCF Fort Edward, NY
(PISM) (Address)
Natrre and attctrem#ngerast Mvinp rvt4s0i+++s dx name of permon aWtortring taerrrafiort;
_Theteaa Merc- ,re 3 Clark St. , Hudson Falls, _NY
(name) ---)
ROW09MMP tO IV d0000 d friend
tamnedFurvenoH ne Carleton Funeral Home, Inc.
IMPORTANT:
i rmprrrwo diet to the boat of my kvwhKVa,the doc;sottsad(has)or Om no)powmaker,dear,batoary,bOm PK.pmer
ceii,cadMediv+e irtVarrt or nxtascNve daubs M hie or her body.(CkOe One)
i rae►►*VW i trace U power end aMhori w*m fu arrarpe for the also ft of the renaft or,4 to dWW the dhspositlon of the
awnstad rarn km that sVry perswei posesse m hev8 slier been removed or may be deskvi td,end agree to pmeac.defend and
save her mie w Pima View Crenreiorbjm ftm aq and eN dolma anti dwnwWs ttcr b a or dwneg es which may be made agdnst diem
by reason of or cormetded with the crerrndw of acid saimb ra es dr*cWd,whedw such daps ar decrtectdls are or are trot whoAy
9 Mae
�r
7*71� Carleton Funeral Home, Inc.
' NY
(SigtreEure end Addnxsa of dx
Signed on this dote: Jan 6 , 2009
_
DispaWan of CremeW RemaMs
1 hereby dined mine View C.reomtork n to dispose of the gated rem fns as blow.
Mail to
Other arren isrrtertt3-Pkreea Woo:
if ptriverin *m of Cx nsied mffw ns is rented,dwck here
114wb iom April 18,2007