Pratt, Donald P. PING Vlew Cemetery $ Crematorium
QuakerT I
Queensbury, NY 12804
1518J 745-4477 or (510) 745-4476
FUNERAL NOMe;
$YIN hQEANn RETURN TIME
DATE 8 TIME REMAINS ARRIVED qT CREMA I ORY:
NAME OF FUNERAL DIR[CTOR DR RSG - DELIVERING
B
R STEREO RESIDENT NO Rf MglryS:
p NAME:
TYPE OF CONTAINER - E"RSEry 10x
PLACE OF DEATH: 72 f)NOY q�q /��✓EY�
ESTIMATED WEIGH F OF REMAINS & CONTAINER
PLACED IN NOLO: - -
_I�L_L11DI
PLACED IN REFRIGERATION: - -'
DATE OF CREMATION, � '�
TIME STARTED; --
.__... T:N -.-TIME COMPLETED. F�
PLACED IN RETORT ��' I I� ZD 2.RETORT ry1N WHICH MOVED
REMAINS WERE CREMATED:
DETAILED REASON FOR DELAY IF REMAINS WERE CISGMgTEpOvik
FROM TIME OF ACCEPTED DELIVERY MORE THAN QO HOURS
NOTE T"e CIRMAT On l04 - -- - "--- - _SHALL Dr ACIAPNED INTnE PERMA"LNT PILE OF THE Cnemnionr
te
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ITATEOf arcs Re
Cemeteries 99
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Y al
Authorization for Cremation and Disposition
The Arm ati FwmMMhas campleltl and signed Prior M dslhary 0 retain am cr Von.
om SEPrEMOER 16.2MO Norman 200 1 bof,
Cm =N Name'. PINE VIEW CREMATORRIM
Address OUN(ER ROAD OIIEENSBURY, W 1280M Wes. 516745417I
CREMATION IS AN IRNEVERSIBLE AM FINAL PROCESS.
Cremation is called avl by plaarg Me remains Of ball owed and elm¢nla MuN the 8llre and a counsel a WMole
may, we afthected Amounted Mat and name. The May and name will lmim Wand corollas sa6ry in except boon and rMa4
which mall Ma wall her hat All cmmtlon.
FdloHfg cRmddon, Ne aeOaMrysell Mks reasonableeRom W remove all of Me remains and comer materiel Arm tte Genie
Tambov. but some minimal dual and marine sill likely M left troll Thuvu tw(Mil¢ Wp Dlnod9u andfaeignmM nalMM
puteramad into smell npdeasaltreefaegnmwanlf I�mne neF ofn¢r Lunretl �lewreimrr rMis ariap '^IYva'iLLaE u�'Mlim'W
pwgnimd m mm l anon
single Im9mant is rePognlnbbas skNelal tlauM.
OPEH NG OF THECOWAINER
The channel may only open the Wntaner heeling the a Mamd human mnalM In lolled ur MMnm¢, auU mIo xnM1rm Its
identity a MdemaaM orto aKUre tMl no myself,ma "Ii night then employcesor damage the IXemalwy ready N
human MallM emdWMr in a ConYimrwMch A nM sultable Mr crem Wn such as ceremonial or rental cal the
or
Wry wall K olre PalN Mal lM be moasd lMO a suttaW mimr Woo It accept M remaalns. T This of
wemaather or the transfer do Small of remainsMuce mndunM home a vnWe will r;and done in State dignify dhadea.
xrFCATION OF D
Name of Dereawd. DO">LD P.PRATT yyilal$lyys; MARRIED
721 NEW VERMDNT RWD BOLTON IANDIfleal IM14
ISM Nr4un PGdreq.
Ponce M Dmlh'. 721 NEW VERMONT ROAD BOLTON UWDING.aT 12M4
sea. l(1M'OF Age. 76 we 05/29/1944 Dam d� owl 72020 EOmmN M160
Default an mMeV ilw A w "annual fall be dellre
FLORENCE CASKET COMPANY/CREMATION CONTAINER?CARBOARD/FIBERBOARD
7F�jye�ajr(8)in CMod d QaposCm,al ONE d the IWoangl
— 1a &are tlw Msigr Wi arms OW dMgr N axle AMtlbniMUlMo mmdBd puWeo to Public
HwMlaw Saaon4201.
-0R
WJe muse no knosiebga Met the detEa el ekwuled Mermen small perform to Public Heats taw,Seodwi 4201 or
MR Wlminng dlredlons fa and musamNcn of his or her remains and IMe era It pwsm(s)fM'nM Me" under Public HMM law
Seakn 0201 and have Nam W aumoriuoemetnon Wme reams dinedmml MYfOurrWtlwreM1lp Wtlx demaasd ie ea
M Iq
DONALD P. PRATT
DOat8B4f(Rw. G!!D) page 1 of 3
Authorization for Cremation and Disposition
7474 tom the arthaow)
NutnWr.2 ceramist SPWSFANFE
1. Aperson OpygrialeU in wNrp PrAdesMbPudic RaslM law Serlion<201131:
R. Tnewrvrvingapouse;
A. The surviving domestic patter;
]. MY mrviving shad frill Years Of ape a Nderl
M Aoctal par
S. A suMWng crunch adherent years of age or Oldx
a. A yawl apmiMa]guardian.
T. AM pawn(N OaNMen Name q age or 01 er2tled to scare In MeeTab and MWiYare aosert in relaotral to me dememd:
& A duly apposed fiduciary OF Me esRle;
9. A coes heed or MMtive Mq tea m¢culM a wrhlan WRm pursuant to Pudic Haelm law Eaton 4M1(7),
10. A MWOlson ofimr of a¢Unly Or a pul admNiental assumed pursuant to thin Surtgale'9i PNc mM,
10a. MY oVrer[9Ron and is moral M pater or Me Oeceayd Me fro has executed awMNn sfatmneM puRuard Is Public HmM
Lau SMm 43o1 m.
/;g mREE grre novel
// 3`_t_It tareoy affirm that lea Near qme demased does nu Paul E . Wray petit pwa®u. Rtiaacvre lmgam,
tt I&10%4va dmm aW Nat end auRr mebria's x2re RmOaBd pMf- bllre Bmmhn q WSAUMarlmtlm Form. FYIIYRb RTOVB
My glwbc OM my rmur In harm b Ms CRmabry and nmnal p mi.
lam_LWe a mr Mat irfN 1w Wa2 Lean glean b JMIES P. MTERMOTT
real ola rem al Of my paraal prggly Or carer Ming Invasion assort and mrsan s ial draw or any fyrafy memLersugar
Mttuard blared as mrve. PINE NEW CREMATORIUM
la M responsible for Me assured q pdwai name tun has WMBNer hwn hn remains of the unrest Pemrul lbms MM In
Ind Or MM this Intended"it In aseOOred Ey this crystal pMeaa send royal W rearlwae after aYM.
(� 1� NW he"asghwhe PINE VIEW CREMATORIUM
fo w
bc1MMMtieI aft aft Mwima.
dgiga(OPTIINJALf
May MRby a thl Me earned Imenal Meal No provide Mblleery by and criminal Ny an samurai
anmaary, If bemad rpm N caary In Ind Opinion 0Me neral director,and M amend Mis b mviM rm to p Me correct name and
ddress of Such alRmate crematory.
FINALMSPOSITION
They peressin andammed la reUire Ma Um ra Mdin.dxumd WOM Ne vem qla:
Name; JAMES P. MCDERll ON EMPLOYEE
Addrem: 9 PINE ST.CHESTERTOWN,NY 13017 Alma: 61ill
The c enataa raWiW InaBmmad an be disposed of art Ml
If and Ne named eN're dwerKKryrepweminrq MeeelWM runaiW.
PINE VW CREMA
TORIUM __ iSa.Vluatlbgm{mm�onq
Me raTynab aNTOWMNERMOTT FUNERAL RCNE INC. Ny defaay
Mrron �a
N persona by readaM mat. pCNALp P. PRATT
DOEl0 f(Rw.Owl ream PpeRg9
Authorization for Cremation and Disposition
�Mme wawMcl
✓�IE MEW CR MW ORI tl WI ilMeremainae rd pgmetl xTnM iM Ny9IXamEcn,
n masnevi ma ATORIUM May shadow W tip ramgna In
an iMmNe�ad¢memx. au]ip WeCWWMM. p�mwox�X
CREMATION F n
(�I ONE IXmB hYowupf
M urn to W And as a NMYnts fa tip pYNW reandm Ra Man Pwtlieae]hwn
and is aeaviCed as rollP.W
Miss understand Nat it Me art IS WO Wall M and Re Wore oareMtl onsurn.W yg0cnai Mind Monsoon may W And W Mi
p/I
t/\ � Mum wvCWW. LMb utlaMsytgNWitrounvpiacMse]wdWrrsa pcutde]
PINE VIEW CRFIMJORIUTORNIM aril Pew the rsx'ratal MWraAU In
•a.awmnl
a d9id Iemlw2ry mNanar Mr dNivWY.
This AuM"ii Fmm uas PMonded by JAMES P. IM9ERMOTT wesaa�Ww
osm"Ma m-rry
flARTON4htl]ERM07 FUNERAL HOME,INC.
9 PINE ST. CHEWERTOWIN W 12612 Pssawmaw
and is Y9rcd by tie Nr4rel diretla as wri W ft enewdon �
Ii how rexNW a 00,11 J copy A 1rva AWIprYBtlW FamM.
This px s)IWnYMd bi iYamtlw panonia)In Matur at dWp on,Ww by aphe and AUMpl wForm, 11he.4sl
at Ban au Y and c PlnenwaN the Intwmarlm Nm WMdI In tlYs AutlwrbNbs Fwm and auawlimi se foregoing.
signed and BEEN day or SEPTEMBER m20
BRENDAMAEPRFTTa� T�- L �
721 NEW VERMOM ROAD BOLTON IANUING,NY falls
pmsdmmw w. ey,n..
WITNESS:
MCOERMOT!
12330 �nr�avmmxr:u..�
n NAIDP MUTT
rwura
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