Jaeger, John Sr. �O O
INE YrEw CE QU rE AND CRE 23 U
M�TERY A 1 \J
I-11 R ROAD, QVEpNSB EMATORIUM
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(518) 745.4476 �Y' KEw YORK 128p4
(S18) 745�•44477
Funeral Director
dace �! Crematl.on Casei+
Te Cremation Started
^'e Cremation
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Town of Queensbtlry
Plus View Cemetery and Crematorium
21 Quaker Road.Queervebuty.Now York. 12504
Cemetery OHioe:(518)745-4476.Crenv*Aurm(518)745-4477
Ali" m it 9on to Cremate
The undasb ned nmpxwb and autwdam Pins view Cmnok km%in sooadarroe wMh and su"m2 to Ms Rules and PAW* k ns b
crerrmle the rer Wh a at
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(sired) ((may) (Stab) (Ew cods)
who died an APPL 4MV4i 1 Z 2D..Z
at ej� .,/,S As4<LS W3P/7AL
(pleoe) (Address)
Name and address at rr on i m *Am rab ve or rams ar parson auvwdtltrg aemeuore
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1 rep men l umt to the babt d avy IswvMarkm the dboeaeed(tme)or @m no)pecemdw.,,,M, tor.bo".batboy peck.power
cA redioacdva implant ar redkmcdm dwios In his or her body.(Ckb One)
1 earthy that I have"power and arrlhartMdM b sM pe forths craalno, or Yw rerrmMrs and b dteot trs dsPoeWon d the
crarmbd remebw,that arty in g 'Posondo=have eM M been rumored ar melt be dseYvlle L and apes 10 pobct.dm in and
sere harnrI N I Pine view 0iamal mi m from»M Odom dales and darrads for bss ar denmges..."A awy be made apelrret them
blr reason d a oor. w etbn d sdd remelm as drecbd.vAndver such derma a demads are or are not wholy
s.
(Address)
d Rdetive or U Repruaerrtetive)
Signed on this dalek
Dispodeon of Oarnoled Ranks
i hereby dkect Plw Vbw Qrembrkrm 10 dbPose Of the aumsted rerndns as fobwlc
fibbM b
Other anengernaib-PMees spedfy:
if puhfaftsdon of cremeled renrairrs kr requested.dre A have
Revialm AprM 18.2D07