Pyle, Kathleen Margaret �
Pio� vic`° (�c C.c'vjLhorim/j
()VN�.C/� .R
~` .()iKj
8
`*«»»»»bU/-y. NY ) 2804
74�-11,41.77 Vr (j,I�j) 74�'4�76
'
�outm( Aomc ��
-_'---��-
R
`-------__ _--����--
N Q~-
--------- »
Dmco[CrCo�*�o^ | �u.|�^ - � -----------
`x Smn,'l ' ----- �
___ � hoC Com|Jc[cd
M
` .��� �o B0|�� __-~-_----------- ''~`"'------- -
Muzdiu 8cj-Hffer,6o.`:
yhrol I^ Kcoo,IL:
TMuo[CmI utior,
' _---_-------_-_
------- x��. ---
_---_-_---------_-_-------__-----_-
xuxx,ks,
-.....
/novc____--'---
PI-A'~ »[Dux{)I
---------����c��___��
j 'l---~-----------'---_______
C�'»»�J VVc|A]lio( kmmxin, m`d C\xxxi»x/ /5-) U --------------
�`�����
WW&1l»IoDu � ' -------------
Nwico[ [\xIorx\ []|rccior or R'" xocnz� Roidm| Dc|iwurix� R ---------����-----
_
Uc��|o| ncxsuo �x ddxy ox wc,c dclivcl-y CNIMVed' c/oom[c/| wo,cd`xn �8homx Cnn`` (`w� o[
xccc|`.cd
--_-_-------
---_---------_--------_-_�--_-_---_-_----'------__---_--------_---_----_---
'--------------------
0c(oaNu»Axor \n w>�i']` Kooxin; ^z ----------------'-----'----------
/xum`�ocd Dh��r --
-'- -----------
'c cnoxnu/i �i)c o[ |}/c [/lmx(o/y
�
Departmorit of state
NEW YOkK Division DIVON 61 OF CIPMFTppfp.s
of
*iTATF Of Pla-.A
Cemeterle!
Albnny.114" i2231 0001
I v
Authorization for Cremation and Disoosifidn
This Aulbodz4flem Form rtivot k*com pie"arid signed prior to delivery of refroA411M For cmmstiorl.
larwary 1,3,2020
.................
...............
Pine Viiw Cr mv atcry
�rem;otw)� Name
2
....................
..........
CRMATION 14 AN!PREVLIKSIBLE AND MMAL PMOCF..ss-
('rpmatlor,ix i-ifri,41 ey0 oy placLv'g the re.,mainz of the dw- sed snd turd oorta1nvrhoj4ir,,q#7trpmaiog hitoa cronlatlon chafftwW401'ef
they efre s,Ojcxqead to;nt#tl*e heat and flame: Them heat am flame wIll'incinisrate and cofmorae everything except bone and lioetal,j
which awe All that will be left after creniatoo. I
Fj)lj0vjjrjq(;ell1liti(ri,vthp oienvatory will trine reswinabie effr rft to rf)= a all of the raqwns rind other materialfrom the Cremation
0*1wn"JAII,W1 EWM(-".IT1101'r,111 dtint arid re*due W41 likely ue laft teft;ra Tr*crematory\*All ae�16*10 ftideiltll anti foreign rrAte.ria!fl'um
I
itiq rfsnlqins and 1hit me dentst ano frjre4�-7 mnitviai-,kA be lji�Pr,%05,d ol ss;bquired by The-,reirrated romaiqc,wil be mehanWelty
pOh,enzba into ,incif pieces And p1a4:*d into to dimignmted cvS,*h)er or tj'rrj, CrvitK0*4 mviain6 generally are pulvorlzed until i10
Ringle fragment is rocognizable;Ns nkpWW ti4sup
...........
f he.ntmlalpty frAy Only()Pon the conlainer hoitkv the Qrl-( *M%Iad hum3n tarnains it; as tQC(A)MP tho
vk I itity r f tint,Ck%,,0M,8(1 Or to el 16ut 0 thrall rite material isk eocl�sed Alch;mIgh t in i", enq p loy-jo a ordaffine the Ore[TlatDry Propedy.- If
1,t;t:w.a s m nAb vi o to delivered in a"Mai per wh loh Is noll si�itablo for ueornatioti such as ceremcnial or r0mtel ca-di k0t,the
a rea)atury wit I i W4 tj We Mat them tv aw no 1:3P moved Into fa�ukla bit-contalyier tteforq it accqptr.oic rwna;nz.
ete tmasivroe rsmtywol of remaine will be rD-1dLikp.P(j befor0aMtness will wi'i be lore."r,privOCY,With 19111tv and rospect.
Name ref i1 i4atNefxi Margafet Pyle
149 1�tiy PZoar.1 Queenai-,toy,New Yadl�,28(47
1.AM Kr Ak(i(irti$�,
Siaratofja linrpital
Plaf�Q ............
S M Age: DOB 04,-:10-i i)42 Date of Death:01-1 2-20X1 EvtirnalW. Weight,
of in tVHH-i;"-rnair1;Z will be
vt
(&TLk2L QLR, N
of M19 AVIOVOrv)
i ArriMe.we tfw dv6m nAvti agent of the deceased de.*nated it m will or writter jn6kjtTieMo00?`AAAd rx1v%,JV1 to Public
HeAth Lavv Ser:flon 4201
OP
h-ve(-,i)Krtoaod�e 4hot the.,domroode h 1atw'ection 20,1 oi a
:'o ro,,diapw-,Itiou of'alb or her rpmains 0.nc IA"am t" hatkfing prjoriiy oeder lltk4ic 1with Law
I and hi V*t*r1jh*,10 auq)(Woo(vilvation of tfi�rernairs of the Jorwow:1. Mly/Our Watonship to ffw,decPased Is as
Kathleen Mafowi4t Pyle
P W,,*I kif-a
ERR in 788 79ud I-S88-469T8IJ8I #9SW :WGNJ 1S7 U:65:El 870Z ET "'9f
A
j Authorization for Cremation and War asition
{ {1rJ.tiN'1 fri�in Nmt ItHi iyHlOh!t
I oy awMVIng Chid elghtmes-,ve rf,<4 tiger or older.
t Id1,}n'riAli+' '� pir4c`rf Jilin •.......,...._.._._..__ ....... :,.,,�. ....,
1 d nr r,tnrr da Wgrrrat6d it,writing r4irstiorit to Public Haallh Low RArtiArt+ti'CI4t ?:
j. Thb sunrivifto atxxiliv.
20• "hfr eufvivfng dr?i WIC partner,
3 Any Kutvivirrg child Fil�l*orf yftft of D~p of oldor, i
A• A y,jrvivrtuj ac9r6111;
b A&Arvk itr;.l uttali'ty 9iciMOp,'ylee►rr OF r{S+r Gr'cAtdfa, I
b A iOwitifly i'.t'v'f'I *d r)IMM4AO;
I / 't+,1y t1G."6i,tll>7 004eor va-HM 01$g*Or CIO&60111W 416Ci,in ft C*WV imd 901rr ixow 'c0tv t ir''B19;I:�r15411�.('?IItP,l9wrE?�€fA't
1 A. A riducWQ v<the 03111 ffi, t '
i S. A r U t friend qi rrafaative WOO ON ox�Gtttatt p y(ritlun lemont pur%µW to Puhiic;Mre#M t.,aw ),
1t1. n(xlnft tirdr!atilcnr cf a cuUpty rw a ubtie adrttlnletra app*tad pursuant tO tifn 91,rmpatO's rxuft F'r4cedure A[Y•
pIl•'e
dAr• Any othal petvon vain is actrrp an behAlf of trw.deco and who has ex fart s ufti!tcn s ant pursuarr'1oNilr,lrc ttR2lfrt
,_Ow$W2d m 4,':(11(7}
rr,ir 41,.f if iF;'f w'of rYre hitluMN)i i
UV at hrrioLy,atft tit tlIal this bntiy of ttio dr®neaetd dut>,a not c;, -Nair n b fiery,,)a" KIww r.,Rtl,rAdlcrar liv4 unplartf.
r;,r rG{ti)t[?ttf'ilue�If VIr:N Nrr,1 pi At,gny mucts rtiAld�r4ciit were rerYtCf ed prior to 1fiQ 9x8C�1 tr�n of this Aufhor7a.pan Frxm, FAtlttnl to r�rttMve
these.items prior to atirmatidr►may rMUR in 1,rrm ka 1h* Wrstl:fr'r and cram tort'{'IN9/SOnnal i
,
t 1
i1we 4e1'firm that lnsbuctkr*hrve been given id_ X Iwo
aka� t{uru pka ;
}, 1<?i]IlrwtirttJ fit?1'cmmwji of any porso,161 Pr OWN or at'101 S►rlra OT v"w►I-ch Afty rscn wg''fint.tickiw br any►rltrOit rvIntKif Ot tt'rd
� l'irr*Vmrov f`,rnTalt4n/ .. ,....�
i rS(>cf)�r,�d wi:,hP,5 t0 Ardb'en�e __ ,•_M•_..,....:�....•,.,_,.•.,.._...,,.
._ __ tk911+JYfC+1•,W 1
is,u,t fatsputoii m ins the rtDttrovkt h+tsHrgUngl nits•�lrnm thft tamer or tram it,* etrt*Wis 01 IM dec+�. pvrsonal mom kit in the
Econtair wr or with the remainn wits he dfretr4"4 by►hs or omaditin prmoss SO c srtnct N Mtr tvt pfttK craniirtlon
Rine NreW 01011t4"
!
UW*horohy r<IIt4 M13* ' -_. ,.W .,-•-._.. —.,_ . .................... ...
m.,.. .......,,..:. . __..:.�._..�._.
i .. .•_•. ... gwMrvrwl
to varruito thn ramains M thrr 6040as",
f�,@ CJc�r4c>tt autlu:,rszeii ir,tcc;f;�iv4x:fin ro'emals�.rertrainrr of t derc:nsasec�front the�rrnm�lfory Is' �,
I '
i fJ:,ice.ttih'ner`:unar�t riCrtltr �
it Mra}n >t SuuH Glens rats,tJew Ynrk 17S I phone:�1 rT4b-tjt ttf
i iT>r1 cran{'Itarrsrt rrrnpina of dtf<wtl�tfari wry:�i dierx�eed:�f Rg irwm !
,
9111irll G'efie:Falls`mile"w'r
it -__. _...r----....--•----.....•._-....,.�..., .•.,... ... .....,.. . _, _.._...—__..__ _.. _.. .._'.,,...-........._...._.r- ..,.....
li f,r drry rad�;m tnv tiMrls•In-ItryiPd abci'.+i fJ0("r,at Wf$R seSMOI)(+?tha varrfalied retrla rw
W,rNV'AWC'( irvltary 1' author'izrt191,a give PQK-570ttof
the rcmanin6 to 3 Kilmer I unatm t•t Aa I.. ..,._...,........_. by u!"f ivttrY
__... - .. _......._...._.._.--- ..,._..�., ,.. -
'$WO 10 M,
I
iri t;n+rwrin or by ivjyrb--'Ad rrtlll,
' KitYiiyaalt►d iarra�r t F-VIA
iNsr•u�o« ewr:t:
OIDS 19913 F(f;:e)y 04116}
,
SBB ja FOR 33dd T--S99-L6EEM. T66T #SSW IIP"F9`IV S/WZJ Maj ZS3 60.6E;TT 0784 ET upf
60 39dd d3WI71SW 8b5LLbLBT5 7,5:00 0ZOZ/ET/T0
Authorization for Cremation and Disposition
-r�tl�tlr:/r�'lrlyt•�r��jJ IS. �''
l'Wo tltar.rystand tlt0i if elo rem iiins Tara t',.il Gls:06'd within 12L days o'y regeY a lom
a
4 ir,, vievw vrernntot
_y. ��aT: ; ;1_ are il• m y dispr.,se of Shta� mains;�n
i
wn it rutri*..v,*J a lilaranei,such cis t.y oiC;t t drig, l
Ft-MATf+LitI+CUt A N
e'ir4thl ONE of£hra fultawr��)
'n IP 9 1'Trt4r�- 1 if' 31 HOIn+'
An+arra^6 bo t!£C;<t an a a arrtxilrioc for the rrerna*4, patTBaina hnw.been plirchi;ls,nrs*'-el
�`Il�'!;•ie,�t.'ri;3E:1:1 ta.`:,tUlit7b4S; '. 5 ..._.�__—_..—._.,.—.
-.— grrtroatrtd ii4virrif'Wa,;a Rdtitiir meal rigid:t�rtt finer may be imod fOr Srr;iubry.
i�i'�a�,r c'}r3r+ykand that if trlti ter°a is too w�'t'ial:to t,oi�A tSrE entire a
'
+i 1
An ur-,is not yet 'AVci„ndorstArd ih+if rio urn is f)ut'Qha piu ided
4 �
rt rlp;el:Er?;{rt/rc8ry rl;r t alncr rt+r coilm'y
,,Ia- o C, Koriop _..._..wAS P,ftCaC.triFCl fil
t7ti,3 AcettrurftaUarr►Tarn!JVd"�11<^�vi 3er tiY-------- ,,... ._
l=,ntq ql FYR'«yrx!lame.
'IA 6. Kil"rery, rurwtral Hon-K — —
,"st N nlrr l;t S a ti ti71p.nr,h,ll1S N w Y(tk
-- if un 89 ,a;;w ncN`a dHi
iS 51pi•P.C�:7y th2 fl.peral zit`m';tor as�•itnPl'tat3 t, ltt�Oecl-lllP�+rr !
WVe Fravz1 tt)(;jbjvtd ca(;rdn•r)lotud oopy of;h.s Authorization on"-
!
The pers n(r')ideas lolv5d lwleaw Nlokm Me parson(s)in cc itrot of disposition,,who by signt-fig tttl Autlionzation Form,att.est(s)
tt,zha mccuracy 3,,wki cornpletetio s of'the infmriliatlon cn talti ed In this AutAbr'lxatty»Fur(ra and 011+A700)010 forp9wirig.
�' .lan".;,y 20
Si ied this day of
ieil A{e Cfu)
S .... ...... .
'17'ySS F�
...._...._.., ,
1
S
S
1
R'}u7tiuC I,.
Wl I rarax,
r
K�Strl«��n IYatpta�ts�i:Ftyla .
j
l � Fagw 3 of 3
57i 1a6A'f Pf me,MYI5) I ll
EH0 .in FOR 999cl T--SBH—US9THIIST #95W [TH60EWBOSAN :WOH,i IS9 TS:ES:ET 8ZOZ. ET Grpf