Bovie, Linda Pine View Cemetery It Crematorium
quaker ROad
Queensbury, ryy 12804
(51 a) 745-4477 Or (518) 745-4476
FUNERAL HOME: - .Y Yam. N
._. RETURN TIME _
DATE & TIME REMAINS ARRIVED AT CREMATORY O TD FE.�NAME OF FUNERAL DIRECTOR OR REGRISTEREO RESIDENT DELIVERING REMAINS.
NAME tw� IIFKr''
- i9s TYPE 0 CARE p
CONTAINER:
PLACE OF DEATH: CrN - E�P`J. P' t'r „G�hxr
ESTIMATED WEIGHT OF REM
AINS 8 CONTAINER
PLACED IN HOLD:
PLACED IN REFRIGERATION -
DATE OF CREMATION. S j0 ZyjE 3 I$ - ---- -
TIME STARTED: _TIME COMPLETED;
PLACED IN RETORT: ___MOVED:
RETORT # IN WHICH REMAINS WERE CREMATED: t'r- �� /� --_—
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN A8 HOURS
FROM TIME OF ACCEPTEO DELIVERY: -
NOTE: THE CREMATIONL EO SMALL ME RETAINEO IN THE PERMANENT FILE OF THE CREMATORY.
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S°TPEAPIIWgIO IYFII ONIRK DIVISIOI Of ° SpePeFCEM�laR IES
OWC°mmercPI,e
Y. Cemeteries
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TNepnhomwt51HIoji
www.em.n.P
Authorization for Cremation and Disposition
Thee AuWwlnWo Form must In aomplei and signed prior UP MIHay ar Him for cram Won.
Wry.May 28. 2020 Number: CIr
Centrally Name: Pore Vlew Commonly
Addrea+. 21 Quaker Rwtl 0udersdyr New yak 128M Perk,_ 518-7N5J477
CREMATION IB AN IRREVERSIBLE AND nNN PROCESS.
Crerrebe is demand vet by pleWg the remains offlea 40WW add C9 N nor holding Me remains IMo a RameEon chamber wrack,
they an subjected to Intense heat and Pane. The beat add flame will iWA W antl comume sNrydrinp exi bona and mWl.
which an all Nat will to IW aM cnmaddn.
Following a6maton the crematory will lake reasonable efforts to rcrmve all of deal and other mabr'al"in the uemaPan
chamber, but some minimal dust eM residue will likely be left behind The cremaory pill s¢Inrate InGtlental and broad met from
Me remains and the madenlal and forego material will be dlyased olas redulrad by law. The aem d remains will be medhaticelry
Adealad I= small piews and pia H into a designated container or end CmnaW remains generally an Pul d untilm
dingle Fragment Is mNnin Ma ae$Wlml ussw.
OPENIRG OF THE CONTAINER
The themalay nay only open Me container holding the universal human remains In limited dwmstar s Such as to confirm the
Ide"of the damaged w to eneore that iw malefielisenslusetl which might injure employees of demape the aema pcpeny. P
human remains an del wM In a cots imr whim Is not ad All for opened on auch as cemmonul or rental dulcet the
mam win "Ulm Nat ate mmlm the moved into a suitable COnmmor before It accepts Me remains. The openmg Of a
ann ry annual me transferor removal of rcmaimwm be conducted battle a vntness and will W done in ismal with dignify and mspW
IDENITFUCAnOINOIFINECEAUSED
Name of Cecened: Wda Male Mantel 3taWs: VAdowxd
Last Known Mde 170 Vwmn St. GKry Falk, law York 12801
Place of Death me Pima at Glem Falk Caper Fin Nursing add ReMbilbWn
Sea: ❑ M IMF Age:72 DDa: 08-15-1947 Date omeam. 05-27-2o2D Ecamate l werm. 150
Da�im'act of mica/ Wiw in which remaiM will be, eM« .
Florence Casket, plywood corrugated cardboard container.
CONTROl OF DISPOSITION
(Poram(a)m cv Fr MMs VO n, "'Idl ONE ofg Mbwng)
I an.M4 are the desgnm agent o1 to deceand designated In a will or wrnwn'mAeumem executed punumd to Pubic
Heats taw Sedum 4201
-0R
sA _ I Arm hi or knowledge Nat the tleceesM executed a will lnalmment onamanl A Public Health Law Section 4201 or
WWII Audi directions for Me dlsMmon M his or her remains and Any are the peduchn 1w'ng priority under Public town Law
Section d201 and have the right to auNorin aematien of the r ns N Ms decreased WmOur relationship to Me demand is We
blw :
Linda Bovie
DOS-1 898-f(Rau. Oil Page 1 of 3
Authorization for Cremation and Disposition
�r=arms rolmwrcwl
INJe Understand mar nMe remains are not aaimed within 120 days of Mrodon
Pine'New Crematory, my rapers M Me remBku in
msmnc+.mrr
an 'imnrcereha manner, w.m as M wnadne.
CREMATION CONTSPIERMRN
Mai ONE of the Statement
An um to be seed as a container M me uemabd remains has Seen purchased from M. S. Karen Fumnl Hems
and is described as Mimed
IM'e und.relavl MetnNa um i.Rc smell to now Ue arrtiroaemakd remeies, anaddMWaldgmmo inermay Saursd MdMivery.
oR-
NA An um is rot pi puM.rsr. eyes mrbatand Mat it W vn is Mrt<SaaN n otherwise provided
Pew vrew Cremmnry will At eethe verhated remaNa m
a red temryrary container Air elderly. nor+ 0..mn
This Aunror4adm Form was provwM by Claire C. Kohnal was executed at
M. S. Itilmer Funnel Home
I Main St, SouM Glens Falls, New York 12803 a xo..xmw
and is signed by Me furrenl director as wages;to N moncoAwn„��
M have re¢ived a ample N mpy of this AunroNaadon Form.
The peregoo sr designed below Were Me presents)in weed 0dlspwltlon.who try signing this Augmentation Farm, aXrsys)
W the mew May and complsbnase 0 Me hibernation centered In MM Autl "ftn Form and auMormas)Mr foregoing.
Signed this 26 day a May m 20
Hedi Moen H et,,& [A/Im
rmi
T
1128anlord 91. dqt 2 Glenn FaXa, New York 4801
sai
WITNESS:
Claire C, Komopka 11932 af�—
w�w„bx r �Noi macaw
11932
Linda More
wese w!
COS185g-I(Rev. 0420) Ppa 3013
Pine View Cemetery and Crematorium
21 Quaker Road
Queensbury, NY 12804
Authorization to Separate Cremated Remains
Funeral Home M B Kilmer Funeral Home, 136 Main Street SGF NY
Director Claire Kongoka ��,,,,//{{�
Date May 28 2020 Tag No. _f
Vwe authorize the separation of the cranazed remains of Linda M Hovie
I/we father agree to hold harmless, indemnify and defend the berein named crematorium as well
as their representatives, from and against all claims, liabilities or damages whatsoever which
may result from this carbonization.
signature Nl c '
Crematory Operator
maM N15
Authorization for Cremation and Disposition
(mnn from the list memo)
Number Deamptlon: My surviving Gild sgnhn yeah of age Or of
1. A gems designated In ending pmsuaM M Public Heats Law$eetlOn 0201(3)I
2. True surviving spouse',
U. The surviving domenc perneri
s My surviving Mite simmer years M ape or oaer;
A Asumi parent
0. Asur ing siding eigMxn years W age or older,
S. A lawfully appointed guardian',
L My pereonls) si0nteen yeme of age or older minted to Were in the etlaM and who lWass dosest In relationship W Me deceasMl
9. A more appointed fiduciary of metal¢',
9. A Clan Mend of relative who has esewMtl a written statement pursuant W Pubk Harem Law SedbM201 O)I
10. Ached fiscal officer of a county or a public admirnAator appointed Wrsutnt to LM Surrogates Court Pmmdure Ad;
10 , My Other person Am is acting on barred of the deceased and who has ereoAetl a wringer statement sursuam to Pudllc Nealm
Lae Sidon 4301(7)
GALL THREE Or Me foMawnge
HMMat herebySfirm Mat the body W Me de'»et does nor mnown a battery, battery pack power call. ra9waive implam,
Or radbadive tloiw and that airy such mffinals were removed pnorto the execution clais AUMorimbon Form. Failure W rerems
Mp items prior W CMMabon may mull in Mmr to Me BAmatury and crematory Personnel.
q 1H IMyalarmMelineVuctima have Open Simon to Dome C. Konmke
regaNiig the removal of any personal property,Or dher Mine Of valor which any pareonwR inog peWw m 9"family member of the
de¢awd wiaMe to prewrve. Pine Vim Creme
N v`vi
isnMres sidefor MeremmalofWmnalitemshamtM ta'rurw M1om Me MMai%Oftnedeceased. PoreonvlltmsnslMin Me
onWimror MM Me remains Sill be desboyed try Moos am pores and cannot the rebini after creme0on.
NM M hereby aNnonae Pled Van Crematory
ove"Or w
for cremate Me remains M Me
l�GPOONAL)
LYv nerepy vuMnnxe the named wheal dlrecmr W provide for delivery to and crenaYon pip an tlhmNe
arematw denied y, if necessary In Me opinion Made Nmml director,and W vmmd Mae Such toProvide M re s Conrad use and
d Ws M Such,Item.@commonly.
FIML DISPOSITION
The person authromedi to recover Me uemated remains of the dwaeed from Me crematory is.
Name: M. B. Kurth Funeral Hone
Address: 130 Main Sir Sash Gore Falls, Now York 1=3 phone: 518-74S81M
The worship remahu Of decrosM wan be dasposetl W as atom'.
1-1 - yIW 1
If for my reason the person manned abuse aces not Was posmuW of the vemated remains
PIreY Crematory Is edrommd W give pcasesebn of
ovierni
Me amain M M. B. Kilmer Funeal Home byykyry.
e In paten or by regaatered mail. r Dusk BCNe
Perverseness
OOS 188P1(Rev. GOO) Ppa 2 W 3