Obituaries

Jay Holland
B: 1948-11-29
D: 2017-05-24
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Holland, Jay
Donald Cauble
B: 1924-11-09
D: 2017-05-24
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Cauble, Donald
James Kennedy
B: 1923-04-16
D: 2017-05-22
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Kennedy, James
Micki Manzo
B: 1966-05-05
D: 2017-05-15
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Manzo, Micki
Michael Lutzko
B: 1942-11-25
D: 2017-05-09
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Lutzko, Michael
Margie Lewis
B: 1923-02-05
D: 2017-05-07
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Lewis, Margie
Marvin Daniel
B: 1952-03-11
D: 2017-04-27
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Daniel, Marvin
Kathryn Core
B: 1923-09-25
D: 2017-04-20
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Core, Kathryn
Dollie Dial
B: 1939-07-09
D: 2017-04-20
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Dial, Dollie
Helen Daley
B: 1927-12-10
D: 2017-04-16
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Daley, Helen
Pauline Barnett
B: 1921-03-06
D: 2017-04-14
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Barnett, Pauline
Frances Bennett
B: 1936-09-30
D: 2017-04-10
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Bennett, Frances
Inez Tucker
B: 1920-06-10
D: 2017-04-10
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Tucker, Inez
Richard Smith
B: 1941-09-16
D: 2017-04-04
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Smith, Richard
Barbara Rowntree
B: 1928-07-13
D: 2017-04-03
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Rowntree, Barbara
Margaret Dickerson
B: 1942-08-25
D: 2017-03-29
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Dickerson, Margaret
Sandra Assenmacher
B: 1944-03-31
D: 2017-03-24
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Assenmacher, Sandra
Dorothy Gleaton
B: 1922-05-29
D: 2017-03-21
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Gleaton, Dorothy
Will Moon
D: 2017-03-20
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Moon, Will
Carol Hollyfield
D: 2017-03-15
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Hollyfield, Carol
John Kiel
B: 1930-07-06
D: 2017-03-06
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Kiel, John

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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:
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 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

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:

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