Thompson, Evelyn R. Fine View Cemeter
Y & Crematorium
Quaker Road
Queensbury, NY 12804
(518) 745-4477 or (518) -145.4476
FUNERAL ROM,. ♦♦,�,�N��
RETURN TIE
M
LATE A TIME REMARRIVED
.__.__._ --AIN$ gRRI V FO AT CREMATORY: 9I
NAME OF FUNERAL DIRECTOR OR ��R��EGG��RODISTERED RESIDENT DELIVERING REMAINS:
Y
NAME: . 'Il^Eutty 'kwpp o _ p�
_._._. _.._._ _C45EN PJ
TYPE OF CONTAINER:
__H_ kLLy_'_ Gd� } fb N1Ivg
PLACE OF DEATH:
ESTIMATED WEIGHT OF REMAINS 8 CONTAINER 1 'LI �
46 PLACED IH HOLD: : ,. Lr
PLACED IN REFRIGERATION:
DATE OF CREMATION
TIME STARTED:
.Jll ME COMPLETED:
PLACED IN RETORT um
—`Ic --1(:>bggt- z:3ap�
RETORT pIN WHO CR ryE MAIN S WEREE C MOVED CREMATED:
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN OB HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE. THE CREMATION o SHALL BE RETAINER IN THE PERMANENT FILE OF THE CREMATORY.
DpenmenlMarm
Mf
EW PORK Division of OIVISIOm ......
nI�
sT.OY
Cemeteries ad Wasi
con;'NY PS44e226
Authorization for Cremation and Disposition
"is IuMpbtlm Form must a emblem.M XBmd p or to colonel of remain 1w Cnmeries.
Oad:SroMdQg Number -fe 193
Crematory Name: only Yew Crematory
aimed got sue M. m'121m s16145Urr
Pdd�: plc.:
CREBRTNNI IS NI Ia11EYEA81BM AND F PROCESS.
Cremation is cited wl by plarm Me Normal of may memo and the barrel meant Me remailm into a chairman col wMuss
cry,amsubjjecdm granted hear and Mine. no Mal all flame we lelnemW all small@e ng m agrat awls and naW,
which am all that will b INI enter cmmNion.
rgbving nematlm, Me mamabry ent hike mawki MOne b rmaue all a me remXne ell Omm mete iel Tom me aemal
chamber CN som samneal dust all tazidue ad likely Ee bfl belled The cremal will mparete normal and foreign m nal from
to managers all the ncldental and foreign me4tal will M msposed of as morprod my,law. The CAmatM remark W it be mxlmiWly
pulverirydimo small plies all placed into a seasonal container or um. Cnme1M mm ins generally am puleeraed until nor
aline hag X modest u molonal agig,.
OPENING OF THE CONTAINER
The gemeLry my only open ma common recall Me uncemated human remains in limited Gwmsome each es W infirm tlV
money of
Clnmelns am Millwysoensure
Ind Met
lWnmw whicha tadmake far'emmetio�each aaommmonal w make mk"We n
kenb�will small We m nme e lns the mass l e er a mandate contain bi itaccap4 to rental no. The notch of e
r the traneedor mmta a mamma en be conducted before a wanim,a nd vine Ce same In privacy, rem right and I" G
IDENnFICAnON OE n
EIa R. TMmal Wdwed
Name of[momen d: madbl them
179 Durent Rd., Blue MwnUin lake.NY 12812
Laet Known Mdrm. -
Odeiwed0 might Carter Soat Fed, N Caere,NY 12M
Pdre W Deem.
sax, Od OF sae:92 DOB: 03107/1928 OmdO ,BR9l2azD borrowed Nat 125Of
Dearograrl of mkeVO w In wNN remains"the
dslaered.
McDonald Container; basic cardboartl cremation container; no interior
(peam(ff in mined ofMq Ill, small ONE ale mannei
I amuse ad ma dmWSI agent W Me dammed daiena ins wl or vent retransmit aeecWd puewm Is Puab
1MM few Small 4201
OR
Me won nortodrdge Met me demaser eaewdan wMtt In¢Wmem WISWma Term pmmXeaM law ;a n -a Me
WIIishipadenoidshe mar dieasior CIoor Mr nmaira all$W metM Yemeni having Won Wpedp mall Law
$eclion02111 and nave me nghl to auNonae cremation site dmaine a1M deceesM. BYIOur MWCnBWptC Oe Mcaaxm le u
fegO'eS Evelyn R. Thompson
Pape t of3
OOS1998-0IRay. °<l1°I
Authorlution for Cremation and Disposition
rshe arow,ry
INYe uMamtaM tbeldMe(Yana ere nm aaim.d YMn l2o a.w a GmmYn,
Pam Vew Crematory
ewsamun mH dgpY.ollM mltlMe
an inetrleveEle nanrlx, wM ea Oyanatlehq.
9811MoNEMge T"Plefe
M um to Le uaM Y a mnbMerhtlw oBlnsW renlYµhesyenruyl®y rynm
am in dYY as babe:
the uldmYM lot n Me um b Raw to lad the wore vxµlal remaiwan edltigwl rgd container mry M who wrMMwy
MlmYrawlpurtllYtl, IN/a wgersund tlwt ilmum ispurNmda WwwgcNdh
%n 4lw Lmµby
ne+er,...vv vAllpv OwnwwU]rwµlµ In
a rgld lemmnry mmeinw(w dNNery
This AUMoha Fµm was Patricia Miller
provgad try Msa Wal
Millar Fullerel Home
495/NYa Poo]J.IrWen ltlw,HT 1]&2 pwewm�.w�.l
aM Is aipnp by he Nnery harbor as whow to its aµculio¢�' �r
]Me µvs remil a completed copy of only AuMoriasden Form
Thepersoms) WMed below I wu the permnla) In sonbol a dlsp Mm,who by signing MIS AUMoµatl Tomr,a t(s)
to Me Ycuncy and comphithisa 0 Me thermal contained In Mile Au dw Ferm aM auMw s)Me Iwo IN.
a Iwgusl 20
pµd Wig —
wil Raw of .20
T
ne TM1ompmn Pym
2;�✓w^"f" tiro,,. 1
new, we
PePence
M /s
- Miller12465
�r)QylJC10./.A�p,M'trsf
♦eusaMm+'.n + asw�r
N,,
w.«., Evelyn R. Thompson
o0SIfil(aev. N120) Repel
I .I I. , iaa I I , I Cremation and Oiaposltion
Inew Cr ''! as if
number
ImaNpyY'r: _
t. The Ape man aeapnauds, Ena Pu and m PUNK Haan Law aecpen eXlt(3),
I. APmUDn do NnaWI
IN. 1M eunMy acar peMor,
a. Any M1i"ung Me eiimmonyears,of age or older,Cann[
5, Aeurvnio
e. Aleo ay mounted
g 8uumnaNiayum On age oe mar,
n'.
T' Any Canon(¢)eynben yyn of ape or ads, name m name',geM1 arm woo lYaM1 do¢eafin Malbnanp P Ne decease];
IT Or Ins least@
11. Amx M1lendwnkfive who has"muba a edged 4ep tpursuant M PUNic Haan Law N M,n.p1(i)I
I Anyo Neal dnim:Ma comw bra PUCpc adminhbatorappymed puma,to Me eudapnp a Lpnl Pry}dun M;
1 Ce. MY OMrnon42n who is acting on mnenmMeMmaam and who has" nd a vmnen enlemwt pu2rmnt b PUNic Haan
Law 6xtlon won wh
(INTA THREE of Me from )
Me herady,any, Mat to bay of the decaaX does NO Corona a armory, darted pack, paver Me, 2Yoamtw Irrylam,
or rataaC wm add Met any such m venal¢wan removed pow M tirr"v hOn Of gas AuMMrsafion Form FeIWM1 tom e
to" Items War to cnmatbn mad,dean In harm NO Ms cmman and cnmamry rymomad.
.j11 IWO affirm Mel lnMumUns have Men named Miter
9rvenM
regarding the removal of any Mrsmtl Parents or oar Mi a y a whin my Pmaon Who bNdv Crew Mindy
nembv of IN
daaaaebwienestop $he, Pine View Crematory
Is AN m$pa ear NO nmovc'of Mmmar item¢died McCommderwhom Me M1mems MMe a.maeed. Personal tamsIslt In Ms
ar e the nner or mmalns"I M awarded q M asm. mPn $and eannm a nMavad after anmsnon,
.: View ninny amnoma Pine View Crematory
xae .w
(IJ nLx OPTIOMaL) No my no"aim atln aawaad.
cnmalpy,tMv hrwdy aWhb Me named mngl director toProvide or"giant to arm rnmmud by an alternate
If dY dnwassor Im the hot mom of no for lM Minor.and to amrrd Me form m Pmvldo M a comp name and
atoms of such mamab c ¢ Ws, ,
FLU IiIii
The Lorton auMemed M Con the cmmand remains of the deraa¢ed from eq
Max HomeFunww Ho wvMtwy b'
Ne,e:
AWnu'. 83P Ny5 Rb.]e, IM4n IeXa,NV II64 bIBGdLptt
Pam'
The P TnmanaINdgeBm wq le dlspvEgymyna:
rmnrndmThr Pare
If N" CrN "IN Colas d mtY ypsamn W tMamled M1nWm.
Mar remain m
Meer Fur llYg r rover Yarrlly6ympM Wswirrq
Md ae
M p.mm wy mps4me melt R. Thompson
oostegat(nay. btno)
goods Rd9