Obituaries

Carolyn Elmer
B: 1928-05-04
D: 2019-04-19
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Elmer, Carolyn
Joan Cook
D: 2019-04-19
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Cook, Joan
Jan Gummel
B: 1945-09-28
D: 2019-04-19
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Gummel, Jan
Joan Burkhart
B: 1944-09-22
D: 2019-04-18
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Burkhart, Joan
Richard Payne
B: 1935-09-08
D: 2019-04-16
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Payne, Richard
James Wasson
B: 1937-10-04
D: 2019-04-16
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Wasson, James
Wilbert Hanlin
D: 2019-04-16
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Hanlin, Wilbert
Charles Thorne, III
B: 1944-08-20
D: 2019-04-16
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Thorne, III, Charles
Wilma Cooper
B: 1932-08-13
D: 2019-04-15
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Cooper, Wilma
William Burnett
B: 1935-04-09
D: 2019-04-15
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Burnett, William
Ramona Smith
B: 1933-06-14
D: 2019-04-15
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Smith, Ramona
Charlie Ballou
B: 1964-05-05
D: 2019-04-15
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Ballou, Charlie
Edith Holmes
B: 1938-09-27
D: 2019-04-15
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Holmes, Edith
Loring Keckley
B: 1946-10-01
D: 2019-04-12
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Keckley, Loring
Kimberly Kautz
B: 1955-12-06
D: 2019-04-12
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Kautz, Kimberly
Christina Harpalas
B: 1946-01-04
D: 2019-04-12
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Harpalas, Christina
John Butts
B: 1934-09-12
D: 2019-04-11
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Butts, John
Onalee Richards
B: 1934-07-28
D: 2019-04-09
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Richards, Onalee
David Staubs
B: 1943-08-11
D: 2019-04-09
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Staubs, David
Angela Bittinger-Burchett
B: 1978-08-13
D: 2019-04-08
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Bittinger-Burchett, Angela
Jeffrey Lehman
B: 1957-02-28
D: 2019-04-07
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Lehman, Jeffrey

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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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