Nichols, Bruce Jr. Town of Queensbury
1011 Certification of Cremation
�3� Pine View Cemetery and Crematory
This certifies that the remains of: Bruce Nichols Jr
were cremated on January f 25 20 24 at the Pine View
(Month) (Day)
Crematorium, Queensbury,New York, and these are the cremated remains of said body.
Date of Death January , 18 20 24 Age 50
(Month) (Day)
Funeral Home Baker Registered No. 90
Authorized Signature)
g )
NICHOLS
Owner
Bruce Nichols
Address Plot
543 Aviation Rd. Oueenshnry, NY 17504 Erie
Phone # Lot #
518- 232- 2865 Kimberly 44H
Deed # Date
4426 1 .29 .24
Cost Foundation Y - N
$700.00
Location
West-Moore
East Kellogg
North-Berry
South-Cudney
Remarks
I ACKNOWLEDGE THE RECEIPT OF THE RULES AND REGULATIONS OF THE
PINE VIEW CEMETERY:
SIGNATURE: ��-�c__‘ DATE:
SIGNATURE: DATE:
Record of Interments
1, 6
e N;cro\s a 1 as
2 7
3 8
4 9
5 10
-V f c-
c.� A
NICHOLS
NAME Bruce Nichols �� Age:
50
Lot Owner: Bruce Nichols
Lot# Erie 44H Grave# 1
Case: Urn
Died: 1 .18.2 4 Interred: 1 .2 9.2 4
Funeral Home: Baker FH
Cemetery: Pine View