Obituaries

Ryan Leeman
B: 1980-06-19
D: 2019-10-22
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Leeman, Ryan
Thomas Dow
D: 2019-10-22
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Dow, Thomas
Doyle Harriman
B: 1971-04-19
D: 2019-10-21
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Harriman, Doyle
Willie Parker
B: 1943-06-04
D: 2019-10-20
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Parker, Willie
Michelle Falone
B: 1964-01-08
D: 2019-10-19
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Falone, Michelle
Demar Poland
B: 1932-10-03
D: 2019-10-19
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Poland, Demar
Rebecca Genest
B: 1958-06-25
D: 2019-10-17
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Genest, Rebecca
Nancy Olson
B: 1941-07-07
D: 2019-10-15
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Olson, Nancy
Maureen Caristi
B: 1949-08-09
D: 2019-10-15
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Caristi, Maureen
Jacquelyn Aubrey
B: 1940-05-02
D: 2019-10-15
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Aubrey, Jacquelyn
J. William "Bill" Quinn
B: 1931-04-14
D: 2019-10-14
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Quinn, J. William "Bill"
Ronald Charles Moll
B: 1937-11-14
D: 2019-10-13
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Moll, Ronald Charles
Robert Wendell Young
B: 1923-07-16
D: 2019-10-12
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Young, Robert Wendell
Raymond Porter
B: 1948-09-20
D: 2019-10-12
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Porter, Raymond
Elwyn Davis
B: 1949-03-17
D: 2019-10-12
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Davis, Elwyn
Ruth Moran
B: 1930-09-10
D: 2019-10-12
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Moran, Ruth
Jane Evelyn McGlauflin
B: 1929-03-04
D: 2019-10-12
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McGlauflin, Jane Evelyn
Leita Washburn
B: 1952-02-14
D: 2019-10-11
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Washburn, Leita
Edward "Eddy" Forrest Smith
B: 1978-09-27
D: 2019-10-10
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Smith, Edward "Eddy" Forrest
Charles Peirce
B: 1947-07-08
D: 2019-10-10
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Peirce, Charles
Robert Bell
B: 1989-07-06
D: 2019-10-10
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Bell, Robert

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I. Biographical Information
Full Name:
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:                  
Please select Grade/Years of Education completed:                  
   
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 You In Death            
Your 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
Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:            
Pallbearers:            
Flower Preference:            
Music Selection:            
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:
         

Miscellaneous Notes and Instructions:

         

             

       

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