Boyer, Joseph i
r7'�T�N OF. .UEE B U9J
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW Y,ORK 12804
(518) 745-4476 (518) 745.4477
Funeral Director r•I� .
Name C
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Date of Cremation
Time Cremation Started
Time Cremation Completed 00
Type of Container CS 1Z/ L,)fu?`9
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Remarks ;
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Town of Queensbury
Pine View Cemetery and CremakAum
21 Quaker Road,Queensbury, New York, 12804
Cemetery Office: (518)745-4476, Crematorium: (518)745-4477 '
Authorization to Cremate
The w4mrsigned requests and ft*wrtws Pine View CremaEorlum,In accordance with and a#pd to Its Rubs and R
cremate the remains ct egubtiona to
Joseph F Boyer M
(Name) //�� (Sex)
2.15 Lo m �� � ✓ ` tc� `f o�4- ��wcJ�r l�. la�'2�
(Sb�eat) (City) (State) (7Jp Code)
YAw died on dayd 11/27/2009 20_
at Glens Falls Hospital Glens Falls NY
(Plem) (Address)
Name and address d an ea liv ft relative or theme of peemn aulttodzi g aanad ___
Leah Boyer 215 Lamplighter Acres , .�„�,
(Name) (Address)
Reiallom tip to the deoeaaed W i f e
Narned Funeral Fiorrre Carleton Funeral Home, Inc.
IMPORTANT-
[represent that to Uto bee[of my knawledg%the dvoeasled(has)or no) maker,deftwillaW,battery,balmy Peck.power
cell,radioecUve In or radfoectWe device In this or her body.
i ow*that I here tuff power and audwrbation to arrange for the cremadon of the renraft and to direct the dispoeKbn of the
cremated rarnains,that any personal possessions have elil mm I n rerthoved or may be deelrnyed,and agree to prdect,defend and
save hartrdesa Pine View Cremetorium from any and all cairns and demands iron bee ar dernages which may be nmdde against them
by reown d or cminected with tfm cninu tion of said nemairrs es directed,whedter such derma ar ria o d8 are or are not wholly
grvur►dless,fafse or fiaudtlartt.
68 Main Street, Hudson Falls, NY
(Witnesst)) (men)
215
(Signature*and latins of ge or Legal Representet
Signed on this date: J i La 2 hS 2.DQ 5
Disposition of Cremated Rerttama
I hereby direct mine View Crerrratmk nt to dispose of the c emeted remains as follows-.
Mail to
Other arremgerrrertts-Please spedfy-
ff ptdverivAm of awnated remains m rsgeed,check here XX
fievh*m,April 18,2=