Kokoletsos, Dorothy A Town of Queensbury
l Certification of Cremation
Pine View Cemetery and Crematory
This certifies that the remains of: Dorothy A Kokoletsos
were cremated on March , 10 20 23 at the Pine View
(Month) (Day)
Crematorium, Queensbury,New York, and these are the cremated remains of said body.
Date of Death March , 7 20 23 Age 87
(Month) (Day)
Funeral Home Regan Denny Stafford Registered No. 227
(Authorized Signature)
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial-permit
Official Funeral Directors Reg.or License#
KOKOLETSOS
NAME Dorothy A Kokoletsos Age: 8 Lim()
Lot Owner: Louise A Kokoletsos
Lot# Uncas Sec.22 Lot 1121 Grave# 5
Case: Urn
Died: 3.7.2 3 Interred:3 .2 0.2 3
Funeral Home: Regan Denny Stafford
Cemetery: pine View
CK;i L .T3CS
Lot No. 1121
.ddre'ss 649 Ge u t . , C1 ear F�11 s ;,T,v. Section No. 22
)wner Louise A. Kokoletsos Plot Unc as
)ate 9/6/69
?pp Superficial ft. @ ; 1.50 per sq. ft .
vocation Rounded on the North by Vscant, East by lot of Thorpe, South by
Path and lot of Carolyn Turner, 'Test by 'Ie cant
:orner Posts
remarks
)eed No. (and changes) 1121
'ayment Record Paid in full Soptombcr 6, 1969
Form No. 01
Record of Interments
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1 1
K Paul Kokoletsos 9/6/69
2
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?r TAIii S e A. Kokoletsos S/24/82 6
3 )( George J. Kokoletsos 8/30/94
4 X Margaret Kokoletsos (09/13/2008) 1 8
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