Obituaries

David Haddix
B: 1929-05-15
D: 2017-07-22
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Haddix, David
Helen Gill
B: 1921-07-16
D: 2017-07-16
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Gill, Helen
Robin Krikke
B: 1960-07-29
D: 2017-07-11
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Krikke, Robin
Maria Snyder
B: 1929-12-02
D: 2017-07-11
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Snyder, Maria
Margery Brown
B: 1931-04-27
D: 2017-07-06
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Brown, Margery
June Frasure
B: 1919-12-04
D: 2017-07-06
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Frasure, June
Mary Cash
B: 1923-04-08
D: 2017-07-04
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Cash, Mary
Evie Patterson
B: 1930-10-12
D: 2017-07-02
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Patterson, Evie
Patricia Bullock
B: 1971-03-25
D: 2017-06-30
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Bullock, Patricia
Barbara Johnson
B: 1928-04-12
D: 2017-06-29
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Johnson, Barbara
James Hergert
B: 1939-09-13
D: 2017-06-28
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Hergert, James
Mary Knieps
B: 1920-08-27
D: 2017-06-24
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Knieps, Mary
Patrick Cleaves
B: 1949-06-12
D: 2017-06-21
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Cleaves, Patrick
Joseph Murray
B: 1931-10-07
D: 2017-06-18
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Murray, Joseph
Ruby Duch
B: 1933-05-29
D: 2017-06-12
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Duch, Ruby
Arthur Mackey
B: 1947-11-05
D: 2017-06-08
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Mackey, Arthur
Timothy Liupakka
B: 1967-07-25
D: 2017-05-30
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Liupakka, Timothy
Doris Wells
B: 1937-02-21
D: 2017-05-29
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Wells, Doris
Doris Wells
B: 1937-02-21
D: 2017-05-29
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Wells, Doris
Eugene Garand
B: 1943-03-03
D: 2017-05-29
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Garand, Eugene
Anthony Loria
B: 1922-08-19
D: 2017-05-22
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Loria, Anthony

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I. Biographical Information
 
Full Name:
Date of Death:
Address1:
Address2:
City Name:
State:
Zip Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
State of Birth:
Highest Education Level:
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Social Security Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded In Death
Occupation:
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:

II. Military Record

Veteran:
Branch of Service:
Serial Number:
Date Enlisted: (month/day/year)
Date of Discharge: (month/day/year)
Rank at Discharge:
Location of a Copy of Discharge (DD214):
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences

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Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
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Jewelry:
Glasses:
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Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

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