Thombs, Rosemarie Julia � 79R
Pine View Cemetery & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME: qde wgd5 ST �— RETURN TIME: IIS�MJN-G� /1_M .
DATES TIME REMAINS ARRIVED AT CREMATORY: ,O - - _I'3 -ZozO
NAME OF FUNERAL DIRECTOR OR REORISTERED RESIDENT DELIVERING REMAINS: -
sA�-��.1
NAME: �OSn Nl "I IL —CASE
ASER %7V
TYPE OF CONTAINER: '� b.& b )jt/t Lo
PLAGE OF DEATH: ) f � 4191,
1
ESTIMATED WEIONT OF REMAINS S CONTAINER Lw/)-i
PLACED IN HOLD:
PLACED IN REFRIGERATION:
DATE OF CREMATION::}7� Oi ^ZOZV
TIME STARTED: II* USE COMPLETED: a.
PLACED IN RETORT. (I*- MOVED: 2 /
RETORTNINWHICH REMAINS WERE CREMATED: NLJ. fAk-rr
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE ME CREMATION LOG SHALL BE RETAINED IN THE PERMANENT FAR OF THE CREMATORY.
• r.M1Departmentra of s
NZU IYORK Division of DIVISION OF CEMETERIES
oeAe'FpaT°fuxlTr. All nvv1n A,aom
Cemeteries
Triennia, 51847dre,aa
tntardi
Abithodzetion for Cremation and Disposition
This ANFW"U Form must he compound and signed prior to fti yof marks Ins mrCre MOn.
pale; 07103/2020 Number 0 -7 92-
pnmMey Nams:pim YNw Crematorium
Abdul Quaker ROM Que bury, NY 12804 From. (518) 745-44]1
CREMATION IS AN lB Ee81BLE AND FINAL FROCE88.
CRmation is orard out by(Acting the remains o1 Ma mossid ed and Me mmeiner holding Me remains into a common UdmherwhTe
IMyare susymedto inbnw Maland flame. TM hemand flame felt incln*M ON rwmute everything eeWt E m4M metal,
which an all that will be left fiber creel
Following demands the monetarywill lake remarmalaefforts m nmawro all of Me remains and doer malenal from the Gematon
comber, bit same minimal dual and residue will likely to kfl behind TMumatorywllla rateinadeMlaMi nmelwielhan
the remains and the incidental and forego madenal will be dhpmed gas register bylaw TM Cttmated remaire wall be rn Mniully
pulverized Into small pieces and placedInto a designated wnymmir or um. CmeWmaimgann$yanpulwr unelm
gins lngment is ragainbable as sk ltoward
OPENING OF THE CONTAINER
The crematory may only open the mMamer holding the unuemaled human remains in limited clrommanms,such as to mrlhrm the
identity of Me damaged or to enaure Me no materialises Josh whin might injure employees or damage the consul pmNmV 9
human remains an defiverM in a conbinerwhich by not suMble for mention such as ceremonial or rental cesb5 the
model will require Mat the mmtlm be moved Into a suitable container before it accepts t1n remains. The cameng of a
container Or the beMhr or remWel N mains,all be conducted Before a witness and will be done In pnwary,with dignity and Mgp
DENTIFICATIOx OF DEC ED
Name of Dercenumed Rosemarie Julia Thomba Manes swua: Named
Lad groan ddl 71 Longview Dave, Apts 174, Ql nsbury, NY 12804
peon of pear:]t Longview grant, Apr 174, Queensbury, NY 1201
sew: O M IN F AN, 89 Doe. 0811111931 O W oast: 07/0=020 flamed wool, 1001bs
CpYnption IXuskeYmnhircr in which reason will M dapWM.
Fiberboardhaltemative Container, Ma"rew l Company
PERSON IN CpNTROL OF OISP MON
Nywyymkg)in wnfM&da ,, small ONE a the 24 W
-�— L 1 em^Nl are Me deaipnaM agent Mere deceased dognand In aas or arisen instrument moral Wnuent N Pubkc
Hill Law Saudi 4201.
OR
1M/e nave no knowledge Met he Mastercard executed a w n instrument agreed W Puble,Hearth Lee section 4201Aa
Wil containing diMione for the dlepoinsan 0No or he random and Am Bra the pemmis)hawing glonN under Publk Heahh use
Saloon 4201 are have Me tgM to auMcnn moral of the remains of Me decimal NyMur nladonshlp Do 1M MttaeW is as
ern
Roeema a Julie Thombs sawl
MS-189i(flew. 04/20) Ppe 1 of
Authorization for Cremation and Disposition
Parent fimn the list before
Numbers #2 Promotion Survir SPOUSEr
L Apeason designated In venting Pursuant to Public XrnM bow 6etli Q01(3):
L They mmHg spouse.
L. Tie mappng domestic real
3. My rural end tribal seen W pe or older',
l AsuMWeg parent
6. A auMnng sidling eighteen years of age or dole[
6. A needfully appeiMea guardian;
T. My persons)epm n years of one or older entitlM to she be In has estate and even beforecloses in relationship m Me tleCYned
S. A duty appointed fiduciary W Me mUce'
g. A close trend or allows who has aucuwd a wdtlen abtarem pursuant to Public dealth Law 3etion 1201pti
10. AMid mnl brown W a county at a public mminbtrator seasonal annual m Me Methanl Court Procedure Pit:
16e Any~paRM who is ae4ng an beaH W Me dK¢ewd and wits,has eventual a name narrowed amended to Public Nealm
use Section 4201(7).
ALL MREE doe spectral
T blew mayor eMrm Nn Me W]y of tee demanded dtts nor cenmin a batery, battery and, power tell, report lmplal,
or Hearin pill and Mat any such normal"in amended prior m 1M enducm d man Manchester Farm. Fail iss nmwa
Mw Nenu pear to minimal mry resold in harm m Me onorall and team Mareanrwl.
W/e alnnn mat'mawNom taw Mengrvenm Sarah Philip
rmeliry Me removal d any prealY pupnly oroMer MIn9 W wllmwniM enY Pence agWrp bekw amyramry nnmOerdM
denased all to parent". Pine Yew Crematorium
is not reponsiae ter the remowl 0 pertmel hems fmm too mnmner or trcm Xw remain$of Me sensate. Pmont halm me In Me
nulrer or adds Me mention will be amboyed by the arelMion praam$eM wnoW M nbYved alter animal
OWa Mnby tudsbrtan Pine flow Crematorium
ro.=.e.n..w
m ar.mm Me rem.me a w aad..e.
�aPnwlu)
INn n.nbv.uMoriza Me nametl Nnent d tea prorme ter aahny m ate wremanon ear an advocate
eaE", If ad �heM Malawi apparel
lit aw opindon of t rrenl alrxmr,enamurena Mb form to plmide Ma comet name area
sts
FINAL MMMON
TM person standard to concede Me vemevd national am dependent M1am the uemamryw:
Neal Regan Dani Stef l Fina l Home Sarah A. Philip
Anderson 53 Quaker Road Oueensbury, NY 128IX Phone: (518) 792-1110
The depressed remains W deceaxd will be demand]IXealdlbm'.
To bay returned W husband, Richert Thombs
Near vry token they n named span Mean sea taw personnel of Me camWlamvn+.
Pine Yew Cremaronum yyrNpdaetlmgtre paeaxmd
el DennyM.mmwm Regan De SbBON FLumral teams Waeryw
fn.w+l.-Me
mpelem W by nONvra0 nail. Ripsemena Julia Themba
aa.aaasm
0O3-11!910-f(Ree, 0120) Pi a3
Authorization for Cremation and Disposition
.. rl�ma ra�a�re)
1 -C� VIM umeWaMinm riames ate had mimed anent ten dare of mention.
Pine View Cremadedum meympwedme nmmn.n
wwu . n
an ImmierebM mernm,such as fey xsnantq.
LRF MON COMMMEMRN
(Wp®IONE o/IM ybumBl
Regan Danny SlaffoM Funeral
_Mum to M uW 6e 9¢nWner W Ne vematM 2mwni las Caen purUae9d M1cm u.....e
and Y headed as fiscom.
Me uMamW that it bw um MRo amallb me the affinsa mvlM mandate.an &Nlifthi rod samurai may be used for delivery.
Mum Mndyelpurmaeed. NVe utlenleM MalXroumuptacltafedIXNMMee pmvNad
Pine Yew Crematorium vdll paw XM uemmm remmn>M
a rNk remrotW mruitvfordeywry, wwwwwun
mis AutlrorOadw Fprmasapmridedby Slash A. PhiIo aas emcmedd
Regan Denrry Stafford Funeml Home
A,A. ...m an
53 Quaker Road, Queensbury, NY 128nd
and is egned W the funeral dnedm as small b its eaeawon a�
lMe have retained a wmple ed will,of this Audhammdon Form.
no parmardm Mammal borax Islam Nee wnonds)In conaml of defecation,wen M sienna Shia Aumamadon Form.m Ual
W has xwrary mal camplmamss dtM Information conWmd In this AUMatrpadon Form and momentum)thm foregalna.
Sign"me 3rd dq'q July 'm 20 — U 4 ^^"'^^—
RiCM1aN E. TM1omba �ilr"J"
71 Drive, Aptpi 74 Qucensbury, NY 12809�crmwd� Nam,
rm... .... saga
Sarah A. Phib
ra..var..,na.e.tw.ex..uismameadmis —
12888
Rosemarie Julia Ttwmbm
yrswasi
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