Loading...
Johnson, Marlene Town m Crea ery nd ry Certification of Cremation Pine View Cemetery and Crematory This certifies Nat dm anuireo[ Marlene Johnson werecrematedon May 2e 2020 at to Pine View (Mont) (WY) Crcmammum, Queensbury,New York, and Nese are to cremaed remains ofsaid l a iy. Dateof DeaN Mry , 22 2020 Age 15 (Mw14) (I)AY) Funeral Home Compassionate Funeral Care Registered No. Bge `! (AuNorrzed Signature) A� NEWYORK STATE DEPARTMENT of HEALTHRuflau mrel aemre, BYflil- Tansit PEllnit IN AMH W.:maueAm"f,R. p.r r phial cerro Ibrpy N,unnbnv sa"Aeenn aMma m.z,,.r,z.zpaa•.r+....m raze o .,aoenn ` ©Xn.mlre,e ❑maem ❑x"XIW ❑We �uWem"Ima W M an�nnnrw ii M monzre, .ywmii" TM Ica PIE s, mae ieFkd DMraNA1NF peyttrXunYr CAnT,M.rVHEM Anamem Off a 't,"Xne ❑6n of Isawn urcMMMy mall, 910111111 GA.n.AAyTaMNwYk DaMnM OQ F Wrmal ON, flefnm M a,d, ,win xda mw AMR,, OM FAVIF ❑zi, all, nneere„ OWDIII o".nmen„ peealisseadw wmm .ea,.f W n,. .m No,A",IMAM wM WIYle reds Weed farem Firm MdmA zap„", Winn t Aem..n,en:nl d vnrmason W h,mby a send M dispose or Me nu man remains a"faned Above as MlWal. Wu ufW sawI oaranxamW, "swing,. NwYou rcMES an enmva mesukn ieenuhe WMwM&Pwd amrrwdrme wmren famadmMmOm M9174 aneaa,mow MM we.ma xa.e,rv.ro,m n�wnmrn,Bed Me, Area. /J L (4 .wa role WX-rs5S WAR r 102 Public Hee➢h Law Sec. 4145(2b) 013879 Raeipt o��?�,Qirrr Human remains of .i ire 10 deliver on S7tr � , W RneRne Yew �oting lM Nloerellwmeouoe al pemti� el O4ec M" F tors g,or Lic tl CERTIFICATE OF DEATH 's'- 00000B11' 39i xmr STklEFl1ENJY9FA _ '° ff,, MA N 0 0 0 0 o m o c x M."w oar r..w ii'e "pI 'j Ms..¢im= s�na: s.,mw. nam,." 1,"w o G� _ a aril w ;m�` '��,: -.,.� M.mom..,..To.,...�,�.''u ,®", o�� ¢Dail�' m�.. ,�..� .o.I ,00,II ,m�.� .eee...,....... ,om..vsx � ussa.rnrvn. os: v475 2, o, o. oPhamamst , Icamwwvh¢m�rr,w,w s:�G o "0 0 5.�. o., it Garekion.c xu. woaes¢ �¢s a w .r. 402"Ya,A4,sare ¢scd oow r+aMmcreg,w•f. Fwwsxm esTrs _ u¢a"w k bFnwuJemiei i4-mv$ nX [ TMMl aNrvammuvn ID30 lame YrYimawwua� "r rim uwmrmwµm.k _ r,Gila a ¢ vz OS 3] mA �Ow.. ¢O�w,.w.,veYwnr.+. ttn SA Gkn¢FYk.xv txn, wumm a"enrrexre ID15 e1� 33 'safi y 3030 a""re OS E 10N r � `N= d0f%wwni ,�i¢Fud ®n o: "o° o. o r omG Coro ®. o� oummmanul JOHNSON NAME Marlene Johnson Age. la Owner: 75 tax Gerald Johnson Cm Seneca 40A Grew Tha Urn 5/2a/2020 marred Fun"Horne 6/3/2020 Compassionate NH m ry: Pine View Liohrl or► L� Ow er - is Q ,um �ohnsoll Address 1 z244' Plot E(0 P_etp_a DELL. Sir, qm,nyv Phone # 4 �1 Lot # `51X - 40 223 - 05-5 -� Deed # Date Cost 656 Foundation Y - N Location Remarks I ACKNOWLEDGE THE RECEIT OF THE RULES AND REGULATIONS OF PINE VIEW CEMETERY: f SIGNATURE: , /�, _ ,, DATE: 5 f ?/ '✓ Record of Interments 1 6 Marlene Johnson DOD 5/72/2n2n 2 & - S•a5. a3 7 Tc.�al,b Ahnssc,q 7. 1 D3 3 8 4 9 5 10 li\ oobs 3 CI �- ►J < n