Morehouse, Eleanor OF
P L E VIEW QUEErV5�BU
t��'i.KPR RO pEMETE'RY A
QUEaNSBURY YORK 12804
NrD CREMATORIUM
(518) 745.4476 1�W
(518) 745-•4-477
Funeral Director
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Town of Queensbury
Piro View Comb"and CnNTW Akan
21 Qtu*"Road,Ousendney.New YorK 12804
Canepefy OWww 518-745-"76,Cm=*xknw 518-745 4477
Auduxtzaidon m Cremate
The un� requests and ault dnw Pkm ViewC'mm6rkm in acmdarm wdh and mibjia to its Rinse and RepAsdons to
aemme the returns of
Eleanor Morehouse Female
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6 Town. Shed Road,.. Mitierva NY.
t5lreet). (CRY) tom) t��)
who dmda, 9th days January 2009
at Adirondack Tri-County 'Nu rsing and Rehab
(Place) {r4ddiress)
Name and address of neatest DAV nerve or name of pawn sudwrtdnq a.mnedom .
Michelle Hitchcock PO Box 550,. Chestertown, NY 12817
(Nam) (mess)
Retatio vd*to the deceased N i e c e
NameofFurmalHome Alexander-Baker Funeral Home
ttNPORTAN7: .
I represerd ow to the best of my knowkKkA the deceased(his)a fm rio)peosntMw.deftft r or any other battery operated
device in tut or tier body. (Cirde One)
I certify that I have*A power and audrort Mm tQ suanoeibr the cromedon of the rearahs and m dkW the cdspoWon'of the
aen wed rem km that ww personal poesessiarts treys eitttsr bean famovwd or maybe destroyed,and agw to pirotect.defend and
save he mkm Pimp View Q rp from any and aD claim and demands for loss or whkh may be made apefnat dram
by rfson�of dr canrWmd wUh the aerrredo of said tenrehs as dlrecled.whether=xh rea ciebins ordanends a are"*wiwuy
proundloss;lobe oc*&dLftc
(Soufte and of or t eo PopasanWvs)
sWWa,Mclate: January 9 , 2009
Disposition of(, wWad Remains
I tmreby dirod Pine View Q mnataium to dispose of the aematea rerrmns as totiow
titan to
O#wmTangeffmft-PkKmsPm:ffr. -FH will pick up
If p ivactzatielon of aemated rertrahs is requested,dm&here_ X,_
Revision:Jyp . OC+
j8f)AR'07
Policies, Rules and Regulations
1. Pine View Crematorium is located on the grounds of Pine View Cemetery.The
crematorium operates Monday through Friday from 7:00am to 3:30pm. Prior telephone
arrangements for the acceptance of remains are necessary. Prearrangements are.
necessary for Saturday cremations.
2. A "Authorization for Cremation"signed by the nearest next of kin is necessary stating
that they do have the power and authority to arrange for the cremation of the remains
and to direct the disposition of the cremated remains, that any personal possessions
have either been removed or may be destroyed and agree to protect,defend and save
harmless Pine View Cemetery and Crematorium from any and all claims and demands
for loss of damages which may be made against them by reason of or connected with
the cremation of said remains and/or disposition of said remains as directed,whether
such claims are, or are not wholly groundless,false or fraudulent.This auation in
addition to a regular burial permit must accompany the remains.
3. All remains must be in a casket or suitable alternate container. Caskets and containers
must be of a combustible material. No styrrofoam or plastic containers will be accepted.
4. Cardiac pacemakers,defibrillators or other battery operated devices must be removed
before any remains will be aged.
5. Cremations will be completed within three working days(72 hours)of receipt of the
Burial Transmit Permit and Authorization to Cremate Form.The cremated remains will
be mailed via Registered U.S. Mail within three days of cremation to the funeral home
handling the service unless other arrangements are made.There will be a$XrW charge
for this service. ems,
6. Cremation,Administration Costs and Recording Fees-
Adult 330' P
Children (age 13 months to 12 years) SISO-W 1 0 LP
-
Infants (stillborn to 12 months) 430<
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