Obituaries

Thomas Zegar
B: 1952-07-21
D: 2019-12-12
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Zegar, Thomas
Dodd Carlson
B: 1947-06-21
D: 2019-12-09
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Carlson, Dodd
Maria Ticiu
B: 1945-02-16
D: 2019-12-08
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Ticiu, Maria
Richard Clark
B: 1934-01-26
D: 2019-12-07
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Clark, Richard
Sharon Sachwitz
B: 1941-02-11
D: 2019-12-04
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Sachwitz, Sharon
Thomas Pedersen
B: 1944-05-10
D: 2019-11-29
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Pedersen, Thomas
Bruce Nielsen
B: 1959-02-11
D: 2019-11-28
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Nielsen, Bruce
Edward Fleury
B: 1956-05-03
D: 2019-11-27
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Fleury, Edward
Anthony Bursott
B: 1984-02-08
D: 2019-11-26
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Bursott, Anthony
Gergory Penoncello
B: 1990-07-02
D: 2019-11-22
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Penoncello, Gergory
Frederick Grant
B: 1935-01-24
D: 2019-11-15
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Grant, Frederick
Thomas Fischer
B: 1932-03-10
D: 2019-11-14
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Fischer, Thomas
Marciel Kiley
B: 1922-02-06
D: 2019-11-12
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Kiley, Marciel
Robert Young
B: 1926-06-23
D: 2019-11-10
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Young, Robert
George Dox
B: 1946-04-08
D: 2019-11-07
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Dox, George
Michael Briese
B: 1941-07-18
D: 2019-11-06
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Briese, Michael
Edwin Schindeldecker
B: 1919-02-16
D: 2019-11-05
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Schindeldecker, Edwin
Cory Slifko
B: 1976-06-17
D: 2019-11-05
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Slifko, Cory
Rose Kramer
B: 1917-10-18
D: 2019-10-30
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Kramer, Rose
Colleen Hover
B: 1924-07-07
D: 2019-10-24
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Hover, Colleen
Betty Stohr
B: 1928-02-26
D: 2019-10-22
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Stohr, Betty

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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:
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Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

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