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Ferrero, William C. Pine View Cemetery & Crematorium Quaker Road Queensburyl NY 12804 (518) 745-4477 or (518) 745-4476 FUNERAL HOME: � y-S• _ qu'RETURN TIME: 6a DATE & TIME REMAINS ARRIVED AT CREMATORY: .y�XN - ;3-,?aao NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS: D :r R� 5 NAME: I/II R.N C -Fe:r1on I 11 CASE 7ft TYPE OF CONTAINER: L4/d M✓A AOY h�jyjN I. PLACE OF DEATH: :?d Cekbhle All eA K 1 yw/ ESTIMATED WEIGHT OF REMAINS 8 CONTAINE I.Q> PLACED IN HOLD: PLACED IN REFRIGERATION: �Z. DATE OF CREMATION: 7IL IYI TIME STARTED: I0'70 An TIME COMPLETED: iZ'aQra PLACED IN RETORT: _—. ..._ 1�MOVED: IL1ypAYii I�'W AT7 RETORT A IN WHICH REMAINS WERE CREMATED: mm yam, Ay DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS FROM TIME OF ACCEPTED DELIVERY: NOTE: THE CREMATION LOG SHALL BE RETurv[o IN THE PERMANENT FILE OF THE CREMATORY. - OMaamMINEM�a I DMre�pN OFtEME prs Comme�tt Audi npr g3)Wm of N 4 of y Division amwnn...rgm o:g&Mm- Cemetenes Lion for Cremation and Dispo^ m ryMre�m.l•a•'•"'EII°°' Authorization a Iya.dPrmr L' pr Form must m mtPl•ba an lots AuM°atr°N frorw mM2a°20 NM Ymr Crynamry (51a1Y�•n Oau'. pflova.- Wma: Oua•uyury.NY l]MN CrcnaWY 2tOmxer0.�• awns anrm are V9RmaiMlMO ecfHaalm� eana bl, paertu. ofw E59_ 4q etui4lerir9 as MMaL mm•W I�IM1race am[ml.m•••Y•rob •aWt CpEMPTgMIS PN mN amfl«ee. abesAndrshe rmm;nn Confusion ��Is Mellon.ys,Mellon. nolme remalmaNdMay Mrm nfalaMture9'•Menfl hOm x blterms•nada ertmacen�^a.jlw ryw 9= malatl thenaelmmttnankalq blrwhar.01MMrwN� matory"• inslly am pw'y Mani de F•IIw+r9 uw'• idue al•relvell es Outos� mremaba mmalm S°mro sM1amfor.ONsome in nntieenmlalNn a nm aMltleslgnemtlw,M••r yeAer�iz m�Net mM MaEm«M•eaw m smreallproe^•�mvak ale bl Wsus. ma,otg eu Ingbirvgmsm Imeu ,fromaineln lMllaE GrWn ma«emamryV y' N � TA1N r. an ,«eompmpiub emW Vwere•a«eam M nNlmr ch Nbnons•m.a co r remTal eu a.Po�e.nLmmg°r•p ;. «emal«Y may furthermore ed•nwreNaWba..lb a Whichn L wb1 tl19nParp en•fine Mm:od.M.roa susuble no done IV num • .mmmamMmreulro m[t dismi momentumlm fram%r or natural°f remelmwlx m a«M•� Memea DOE =ED Manfal5bew' IMF NM1xum C_2:!O Named interested qmy 0mw' NY 13N1 z3 CmW NV Last Knwm AMrcas: 2' CWke W III Gaea o NY "'0' Plain•f Death �a 03/161190 Dm&m DTmlrzozo Eeamaba w.ara L£0 1) Sea'. ©M ❑F A•R'. Dew o•a6Nag«mbotfmwns remms w11 as dmi'ared Cardboard Box wMOodea Beae ry«wnb'9� �ONE a0a lolfmsi•g) IM PwsuBnim Pon: 1 «nnYe am me eMiga area agent of me eMe.msWnale] m a Mn of wrote Ns1m•mnleattu rlaam taw sealoeuot. 1 Io�N'- wrlmn InvWmed pews,e,Pua¢"Wo,Law Sect®r azY IMb fuve m xnoM 'aNembM ae or Ma M•aa• mm.Wu^*a e«••aandmeremtlee of me see Nhe. Myqur relvmmnlpm Namm.e•a) x Wmrg GAtiMsf«me tllsgaebm Ol lis«her rem%•s and ley"anmeGer.•MSl naving Peoely uneerpuetic Haa section 4201 am nary mere William C. Ferrero Pd OOSf@Jbl(Rw.Darz01 Authorization for Cremation and Disposition I OndeNrrOm Me ose bMw) µgoo Feimm(n1k) number Oes`nphan: y 1. A reason Nominated In vntirg pursuunt to PUNK Indiana Lee Semon<301(3)', g. TM ewn'nng sp0uae: m The Samar) rameam Penner, 3. Airy Marring chlld careen ream Wage a real a. Aaurrrving pared. a. A surviving moung scheme years of one or d]er & A leWully appolntM guamm: T. MyMmon(s)will years of We or alder earned to share In Me eeadde and who team dQo In relsliOl W the 0ereeee]', L A duly appointed Mail of the aSi 8. A days k a rdehueecho has erecumd a worn srn OM purswrit to PAIA mallh Lew Section 4R01(7), 10. A chain Now oltimr W a wuntya a public administrator appoWed pursuer to Me Surrryab'a Coon Proonetlure Act. 1W. My oNa"man who is Real on Oman W the decal and who half exei a w n ammmant ryrsumt M Pudic HaWh Law Section 42010). IhW—,LaadI�ALL rat 0MO lWaumal IM4 hereby emrm Net me lNAyofthe dewffiBd dean net cUl a MMry, mil peal pDirer To redmctlwlmplanl, arratlUl08ctiva deuvnand realer Hoch matenab Wre mmond prvx tONe ersa4on DtMUAutlroNsa6M Fom. Fallum W mmove i e Ltems War OR cmnetim may mutt In ham be Me mm Wry and cromebry pemonmt. IMAM arms That iiutNNoM have Cean green W Rolland G. Mamma reOeNing the rental of any Porsonel pOcenY craNer N'mg Dlvtlue which any pars'w- s)Mr)GetwaaM famlNms WrWIM deal winners W gwwric Rre View Cremabry c u nor respcmlde far Ne mmoval otPononal hams firma the Annual or ham the remains Nthe dOrea Pemonalname"In We container tainer or wlh 1M remains MII be destroyed W Me cmnatlon prccsas and cannot ha reMawd afar crem&Um. ^nJ�Nye hareOy auNonu From Ukhor Carl wn, VV W=moo the mmalm 0 vie dome I�DPTIONAL) Ifwe heroby authoal PB named funeral dlrepor W provide for delivery W and enma on try an tlwmeW emry.If deemed necessary In Me minlw W Me funeral dlrs r,and W amend NW form to pmmde Me comat rams and ceame W such almmaW mmatury. FINALDISPMITION TM person aml A aner"to mmaud rower cMe�M1vn the'CRmamrym Name Canpaaslomu Fungal Care Amress. iO3 Mega Aw.. memory Sall W 138% paborry B)59HMA The cremeW remcna W dese»]will as musical W as Mbav' Reach TO Family If he any me�day Mral named above vies not Wu Dwaesaon Of Me me remains. PYKY Cremel m eltldaaed W arva Wsso of Ms mnlroW CmmpwloMe Funeral Care, Inc by mllvaiy xmW inmmntt0 "Who mall. po�eexw 'MNam C.Fgrem awsardwe CCm.Ima&f(Ray.04rz0) Pal Authorization for Cremation and Disposition (in"me www,.nv y lAl unmrstana and if the remains am not slashed xMln 1 M an ar<mmaoon, VVVVVV grevW cremelon hey anneal of the nehamm an lrratavadla manner even as W scaaerinp. rcs.ewo.n.m CREMATION COWANEWRN (orgaONE AIMS hathei An um to be used as a aMal Imthe vemekd masers Ism 0.yn pundial hmm and Iaaaaided as lessen: IMb urWrshnd that It the um is lw mall to MO the snare aemM howl an eaNOnal r ad wnt imr may Ee mass Ma fevaq. J An umi IM yes piromsa. IAb undemand MN it N an,A,puttM1atla or otlleMY pro dad D FIM VI9a CPomebry will plain the email namimm a rill Rmoval PonUiM An delivery, ds+wc ww TIU AU o2atlon Form was pmvlded by Rolland G. Hoag wa$emculN at CempmHiolub Fun al Care, Inca 403 Msse Ave, Saral SpunOe, NY 10W I and is wBmd M the homeal s alter as xNmu lose eacul UVAi saw received a wmpMed copy,of Mk Authorization Form. They amteane Identified Wall l persons)imm day to and Gwinplelente a sin babonmeen mosained I sle) es AUlawasoma home n Fo end submarine)the Russelrrp. Signed tb 3a del Jay 2020 Wendy Fines ty-4� .�QnnofV7 33 Costae Hill Road, Gamei NY iml �a Al WITNESS: Rolland G. HwB I11fi36 � v"vsl Mwoi>t.N�ehnl again C Femm min w 'oesa DOS989Sd(Rev. 0060) Pye3M3