LaRose, Matthew rro r4N OF. QUEEN,5BU9�
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4477
Funeral Director
Name NII4440 Case # 3( 3
Date of Cremation ISu t Z4 2001
Time Cremation Started 9, 3 U
Time Cremation Completed
Type of Container �rcl�pq� C�� ��Q�(@ F, P6 CAY
Remarks :
MAC j moues Ah
ivy ues la u , 5184991050 P 213,y�
41
f
Towlh of Quow"L 'y
Pint VW w C mw"y wW C4rtlltdbf(tKt'1
21 Qumkw Rood,Qt11Mrobuary,Now York. 12WX
Conwi ry Ofka-(51 a)745-4478,Crwnoo wn:(518)746.4477
Audwi=fon WC MO
TM ur�ralprw!raquara and aWhcata�a P'IneVisw Crarealartlan,h aaoadras w�iMnd ruF�+to M Rutty end tlapuiMtaw a
aeaNnaM d1s wrnslar ek
i-
_tea�,,L,.�_>,l�u:-�•.�5 c. �`'4 v 1c_��C11,� ,�+-1 .._�'-'�`�rj�
(Dow a*Code)
wrra dad on L dry d
� 1" �l ���c�ici;-1 1, t': , �,i'� L'\•�} �_.1.'�1. —k.:�.;1 �,f.�rtC� t-�ilt' f-���.>(�.t1�, tl.i1`�
(f� (AddfMi)
trirrw 04 aodobs of rAmrwr bft miadrs or na Of pMwon I Groom e
�.r _aiG V�1<.�•-ttr'�(c.1i• jC•_., !rL\1<'��Lat.. 40
118tallorail�bllydaGraaad f1-��, �.,..�_ _ _
rtaraa
t11 PORTAKT;
i nwnm arrt mat to do boo cif ary IarowYrdpa,vw dammed(hm)or(M s ro)roawkdw,d.0r0 .,kwow y,bafty pm*,Power'
ad,nmkddbve 1 iilplMlt or Kftmnm v do obe ti 10 or rb t".tCMb Or*
aartM�Thal t tlava fY1 po�wrr Md MAIkxIRMtOd tq tlrYarl�Oar tMts txatrararl of ttha arnarkls and>b d�bra dl�Paalthx+d tha �
w n oW.m.u* !Mai Nq parMd powaraM d haw►Mtw bsM ranwV Oslo and
am! 'I@@ P'Mn Vl4w Cmvwmtm tm sr►y aid a1 alias and dalrlanda tow loos w danarprw aA,fd►arty+�m.da syrtnrt ltam
br ramm vl or m—ctrd vft t►aMnaMon d oaid rwn�slns rrr df>lci�d,+at�rar wct�c na or de�inar a�d+Mr not yr +fir
pou�daa�ib CRO WA L r
kA, Lk
(ltppnnrra L.YM RrtxulMwtiM)vb) _--'�--
and Add<aaa d tiaYNa ar
r
awwc an tt dwa:
OlaPos�t)on ddNanw.d t�anWb—
I h1rWl Y Ow Pty VWW CraawwWm ID dWp m of Mtr aniwtMtd its wm#a is am,
Moto----
cow wmgwwwt-PWOO 41KNY _
n Puti+artweton d ara atad
NtwWkw,Jwu"1,20M
r