Obituaries

Eunice Mock
B: 1923-08-07
D: 2019-11-08
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Mock, Eunice
Patricia Hoosack
B: 1933-03-23
D: 2019-11-02
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Hoosack, Patricia
Frances Walker
B: 1935-06-02
D: 2019-10-31
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Walker, Frances
Stephen Dow
D: 2019-10-30
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Dow, Stephen
William Langley
B: 1939-08-21
D: 2019-10-30
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Langley, William
Esther Tarbell
B: 1921-09-12
D: 2019-10-24
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Tarbell, Esther
Karen English
B: 1938-03-13
D: 2019-10-22
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English, Karen
Charles Pinney
B: 1951-11-25
D: 2019-10-21
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Pinney, Charles
Doris Bagley
D: 2019-10-20
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Bagley, Doris
Irene Nunneley
B: 1933-11-05
D: 2019-10-20
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Nunneley, Irene
Lillian Dahlberg
D: 2019-10-19
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Dahlberg, Lillian
Nancy Hill
B: 1970-01-06
D: 2019-10-16
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Hill, Nancy
Troy Ellis
B: 1965-12-27
D: 2019-10-13
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Ellis, Troy
Casey Akehurst
B: 1966-05-25
D: 2019-10-12
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Akehurst, Casey
Jeannette Campbell
B: 1969-04-20
D: 2019-10-12
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Campbell, Jeannette
Shirley Dean
B: 1925-03-23
D: 2019-10-05
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Dean, Shirley
James Smith
D: 2019-10-03
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Smith, James
Judy Strickland
B: 1943-12-02
D: 2019-09-19
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Strickland, Judy
Susan Berry
B: 1956-10-02
D: 2019-09-16
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Berry, Susan
Siarhei Pantsialeyeu
B: 1983-07-30
D: 2019-09-15
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Pantsialeyeu, Siarhei
Rene Allard
B: 1926-09-18
D: 2019-09-13
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Allard, Rene

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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:

Miscellaneous Notes and Instructions:

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