Obituaries

Roger Lawrence Murphy, Sr.
B: 1946-08-31
D: 2017-09-18
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Murphy, Sr., Roger Lawrence
Christina Maxine Read
B: 1926-01-02
D: 2017-09-17
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Read, Christina Maxine
Norman Rossignol, Sr.
B: 1925-11-18
D: 2017-09-16
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Rossignol, Sr., Norman
Klare Berntson
B: 1931-07-31
D: 2017-09-16
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Berntson, Klare
Phyllis Harrington
B: 1928-01-30
D: 2017-09-13
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Harrington, Phyllis
Hazel Hopkins
B: 1928-01-13
D: 2017-09-12
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Hopkins, Hazel
Bernard Shaw
B: 1928-09-16
D: 2017-09-11
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Shaw, Bernard
Rose-Anne Hall
B: 1934-12-27
D: 2017-09-11
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Hall, Rose-Anne
Barbara Frederick
B: 1962-09-12
D: 2017-09-10
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Frederick, Barbara
William Carnevale
B: 1948-02-12
D: 2017-09-10
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Carnevale, William
Larry Charloux
B: 1956-11-29
D: 2017-09-09
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Charloux, Larry
Winifred Bostock
B: 1924-03-18
D: 2017-09-07
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Bostock, Winifred
Susie Dwelley Seymour
B: 1934-05-16
D: 2017-09-04
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Seymour, Susie Dwelley
Robert Fernald
B: 1950-09-09
D: 2017-09-01
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Fernald, Robert
Evangeline Mitchell
B: 1929-08-31
D: 2017-08-31
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Mitchell, Evangeline
Avis Parker
B: 1924-09-22
D: 2017-08-30
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Parker, Avis
Frank Bradsell
B: 1922-11-30
D: 2017-08-29
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Bradsell, Frank
Alan Hutchinson
B: 1947-01-27
D: 2017-08-27
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Hutchinson, Alan
Warren Arbo
B: 1930-12-24
D: 2017-08-24
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Arbo, Warren
Marjorie Moore
B: 1932-09-05
D: 2017-08-21
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Moore , Marjorie
Debra Lawrence
B: 1956-08-14
D: 2017-08-20
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Lawrence, Debra

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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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