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P A R K S I D E M6MO1tIAI. CHAPBIS, Llc. BN ti
13tS XftQME AVENUE 11.60 CUEENS tlYO. 157 flAT1U>iN AYE.
110N11. N. Y. IObs2 r01~t NIll3, N. Y. 1177s 1100KIYN, N. Y. 11131 ~
to 1.7170 Tr,?I.w s.vooo oE..r 1•lsoo
11/01lOADWAY 11 GlvE1T STlEET 710 71r iT1ElT
NEw Y01R, N. Y. NAt1130N, N. Y. MIAMI 1EACN, r10110A
lE 3.110 (11q tE 7.IIOO t3os1 uNl.. Iamb
ns loNts tEACN 10A0 1000 lEnalo Trlc~. »s 11oAOwAY - ~
10CiY1llE 0=NT1E, N. Y. W'OOD1UtY, N. Y. MONTICEll0, N. Y.
(s16) TN ?1616 (Slq TN 1.1616 m~17K1yM
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Received from:.. ~ ---.......Dote of Funera(.~~+..~.....-. ;
For Funeral 7 '-4
Expenses of:.---~'~_-•-----
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(.'r+ b ~z-sip- L ~i( !1~H-~ t/
The Sum of:.~.~-........_.`.`~..-~-------- ----~-K ....f..- _
~ p Cash -
E TOTAL.~"J----
Sctvs this rettript. "Partied PapnNnf•• w81 riot bo noted on your -~Ppji~side a Chapels, inc.
irwoico. Staterll~nt will follow showing all paynlo~rts nwd~. ~ G%j-~' e
PLEASE MAIL ALL FUTURE REMITTANCES TO: 98-60 QUEENS BOULEV .FOREST ILLS, NEW YORK 11374
ALL QUESTIONS REGARDING THIS R6C8/T OR 8tii CALL: 896.95 1
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