Babua, Kayla Stephine Pine View Cemetery 8, Crematorium
Quaker Road
Queensburyl NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME: no rU,1.1
—ZL _._ RETURN TIME
DATE 8 TIME REMAINS ARRIVED AT CR
EMATORY' _ _ PIT Al
NAMENAME OF FUNERAL DIRECTOR OR gEGgISTEREO gE54DENT DELIVERING REMAINS:
NAME:
TYPE OF CONTAINER: /'- --CASEµ G7�
PLACE OF DEATH: _ MAI
1�L"�
ESTIMATED WEIGHT OF REMAINS & CONTAINER__
PLACED IN HOLD: - - - -'1soA. _
PLACED IN REFRIGERATION _ �—
DATE OF CREMATION:
TIME STARTED; _LOB ,rlJ
—^"`�----____TIME COMPLETED. 'J
PLACED IN RETORT: iD B p -
MOVED: Its
RETORT IN WHICH REMAINS WERE CREMATE4 rl a A�
DETAILED REASON FOR DELAY IF REMAINS WERE MORE R'
CREMATEDMORE THAN CR HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE: THE CREMATION LOG SHALL - --��-EEPETAINEO1NTHEPENMANENT FILE OF THE CPEMwTORY.
M AXe
IE 711tK Division of n.Iwmm:m Wame
small DWM OF CEMETERIES
DPPORaVxlry. Cemeteriesone Ccmme,re sleds
99 Priori Amore
audely NY 31 door
Nro nee,POLIX6336
Authorization for Cremation and Ulsposluon
This AUMemaum Form must be CmnplWtl and signed prior to artery of remains for Crm m.
ogre: May 30.3030 Number:_ 1a7(7
Cremalpy Name Pine Yiaw Cme Wa
Address: 210uaker Road OueensWry, New VOM1 13BIM per, siales n
CREMAMN IS AN IRREVERSIBLE AND FINAL PROCEW.
Counsel Carried Put by plating the remains Of Ill decemN art hie container noltling Me remains'WO Crmation Chambervem
tl are suLye balance heelaM flame. The Mat and flan will ImIMOmb and Consume mryMing eatepl boll art matt
which Am all tlut will M laid after Cremation
Following MMAM. MC Mmalory volt lake reasonable aTMs to remove all Of the remain$antl oNx mIDwial form the aanation
Chamber, bid cone minimal duet and residue will Gkely be left behind. TM uc Mory will separate Inuoenbl antl bregn material hoot
the remains end the i cdeMel and foreign malalal volt be disposed Was required bylaw. TheaemetM remains xgl be meahenlC lly
sulversed Into total pieces and stood Into a designated Painful m. Cr ah re 4mganmlryampulwda urdlnd
mgle fmamenl IS mcogninble As skated damage,
OPE
The rrem 10q"re only also Me Containerhoming the Can-cwMAg d human remains In limited prwm¢larcz$ dells es W C nlmm Me
iden tity Oft"dw axed or to ensure tat no material is erased which might injure employsens or damage the court property. If
human remains are delivered in a comainerwhieh is not suitable for cremation such as ceremonial or rental casket Me
wmatary will mgulm Mat that mm be moved moved Ines a suitable contatn re 14 erbefoCCapb the remains. The opening of a
mairor Or Metransferorremovalmreminsvnubemndu dMfineawM aMwillbedoneinplvAly willdRnhyantlrespea.
IDENTIFICATION
Name of Dewaeed: Pat Stepermte 9abua Single
MarMl Status:
Last Known Address. U Feller Dam Road Sound Glam Falls York 13803
Piece 0f 0eath Alpert MC tCehier
sea: DM IMF Age:32 Doe: 3-30-1988 Data OfD : h-ig-zoz0 Eadmabd we9m 150
Description W ceakeu¢nfaner in wMm remans wall be delivered.
Florence Casket, plywood conugetad cardboard container.
pERsox NCONTROL
lPersm(xl In mnnaWd'aqulron uudarONE orrlm Idb")
1 amNJe are this designated agent of the de¢esed designated in a wall or wa ivWmenr$,$"ad pol to Public
H"M law Secdm 4301.
-0R-
rMt�o IM1Ne have no knowledge that the demasetl Credited a Oman sommort pursuant to Public Heats law$Mton 4201 Wa
will Ponlaintng diamonds for to disposition Ofhis Orher remains and Ill am the perecn(s) having worry under PUNK IkaXh Law
Section 4301 and Move the right to euMwiae vntrast of the Nor of Me decreased. WIOUr mledonshlp to Me deuamed In so
follows:
Kayla Stephanine Babus
Dosmg6gFar w110) Page t of 3
Authorimbon for Cremation and Disposition
rlm„Tnarpthe moseeng)
11� WAS undemend that XlM remains are 1plcbimetwMln 1M Myra aaamaYM.
Fine vrex caismary
w»ac.�mn may diapc»ame remamam
an lwhereabk manner, Inch as Ey shom I
CPEYATION COHTAINERNR
]laded Ow of muoxrng)
An um to be used as a comner for me immeMt rsrWna has Mean purchased Was M. B. Kikwr Funeral Home
and is described as follows;:
IMb undemand had Jme um as and"I b met Me SIMI vemaMd rt abler,AS,pditiorel rgb mmaner my Ue seed tor Mand,.
-OR-
NIP An um is M yet WrtlraM. W.b understand mat0no um is PuNgeM a WierileepsuMed
PIreY cnmetwy
M.macnwan wll plq tlq vwrWed mad in
a rapid Ampsmrym WnerM doe ery.
This AUMwha Form WAS goaded W Cain C. Nonopka wes executed at
M. B. Miner Funeral Hama aow.n
fEMain$1. SOUM Gkm Fals, New Tork lPBW eWsa mm win
bM a Signed by the funeral i inpor as wines is Its exemten
IMb have re¢rved a uanpkted may a this Autlmtlaatlm Farm.
,hemp wn(s)Me fkd Celow Maine andpersowel in aonbol a iispwltlon,"a 4signing Mis AUMonaetion Farm, atl ks)
2cy and CamPlebnew,&the nevrmeless soaalMtl In this AUMorl "m Form and authorize(e)Ma arsgoing.
signed M4 20 day at May m 20
Wheat Porway FAO Dom /
V
1870 Couay R131 G2milk,Nw'Yak 1202
WITREBg:
Clain C. KorgNe
11g]2wurTwsnrwx.++r ew✓a.uvam+p..r ^� ��
DOS lggBf(Rev SAW) PW3 a3
Pine View Cemetery Mid Cremaloriuur
21 Quaker Rmd
Queeusbuty, NY I2804
Authorization to Separate Cremated Remains
Punenl Houk rh 134 i .-v._. u�
�T__A
author a rho scpal:diun of dK! cmmnm<I mmNns of
ry(1p5p� l.rayA__ ______
Uwe further:µ em hold hanr oll'y mM ddend the Leminmined rnmla6OlUm as wdl
es the rcpmummbcs, floor .m dl dalon, Iiahiiitics or doy�c aus whaem%cr which may
resUdt 16rm diix: UR1101 rnio/n.
S�ymaLLn�Ory i .v�
Crcmuory 0l>rramr _________ —_______4 - ------------
3 Bsg s hd�