Obituaries

Molly Craddock
B: 1959-01-13
D: 2018-06-13
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Craddock, Molly
Billy Nicholas
B: 1957-12-28
D: 2018-06-01
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Nicholas, Billy
Carla Pottorff
B: 1940-07-14
D: 2018-05-19
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Pottorff, Carla
Wayne Peters
B: 1943-12-04
D: 2018-05-19
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Peters, Wayne
Glen Simon
B: 1960-10-21
D: 2018-05-18
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Simon, Glen
William Holcomb
B: 1935-10-01
D: 2018-05-16
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Holcomb, William
Charles LaRocca
B: 1994-02-28
D: 2018-04-22
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LaRocca, Charles
Pearlie Caudo
B: 1940-12-27
D: 2018-04-21
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Caudo, Pearlie
Ralph Eikenhorst
B: 1930-03-06
D: 2018-04-18
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Eikenhorst, Ralph
David Redd
B: 1944-05-19
D: 2018-04-10
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Redd, David
Renetta Rozas
B: 1961-05-04
D: 2018-04-09
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Rozas, Renetta
James Pearce
D: 2018-04-08
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Pearce, James
Betty Provost
B: 1935-06-29
D: 2018-04-06
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Provost, Betty
Constance Griswold
B: 1943-11-12
D: 2018-04-02
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Griswold, Constance
Rickey Vallier
B: 1959-08-22
D: 2018-03-31
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Vallier, Rickey
Carol Hollier
B: 1956-04-20
D: 2018-03-27
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Hollier, Carol
Nathan Roy Powell
B: 1952-05-26
D: 2018-03-15
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Powell, Nathan Roy
Loretta O'Quain
B: 1935-03-04
D: 2018-03-12
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O'Quain, Loretta
Jack Fogelman
B: 1949-04-06
D: 2018-03-12
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Fogelman, Jack
Jennifer Carpenter
B: 1957-05-21
D: 2018-03-12
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Carpenter, Jennifer
Raymond Martin
B: 1938-10-04
D: 2018-03-07
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Martin, Raymond

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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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