Obituaries

James Daly
B: 1951-09-14
D: 2017-08-07
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Daly, James
Karlene Magnuson
B: 1961-04-23
D: 2017-07-09
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Magnuson, Karlene
John Phillips
B: 1929-05-01
D: 2017-06-24
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Phillips , John
Steven Winter
B: 1985-11-06
D: 2017-06-18
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Winter, Steven
Stephen Ayotte
B: 1948-12-07
D: 2017-05-15
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Ayotte, Stephen
Suzanne Musser
B: 1934-05-03
D: 2017-05-12
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Musser, Suzanne
Dennis Klaus
B: 1946-11-19
D: 2017-05-06
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Klaus, Dennis
Kazimierz Charlie Kryszpin
B: 1936-07-08
D: 2017-05-04
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Kryszpin, Kazimierz Charlie
Anna Osowiecki
B: 1919-06-21
D: 2017-04-27
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Osowiecki, Anna
Lawrence Bulgier
B: 1926-10-30
D: 2017-04-20
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Bulgier, Lawrence
Helen Drenzek
B: 1923-08-27
D: 2017-03-27
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Drenzek, Helen
June Czerpak
B: 1930-06-05
D: 2017-03-25
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Czerpak, June
Linda Knoop
B: 1941-01-24
D: 2017-03-08
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Knoop, Linda
Shirley Holcomb
B: 1932-12-20
D: 2017-02-27
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Holcomb, Shirley
Russell Cobb
B: 1925-09-23
D: 2017-02-27
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Cobb, Russell
Thomas Sheridan
B: 1931-05-29
D: 2017-02-20
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Sheridan, Thomas
H. Ralph Gelineau
B: 1923-09-23
D: 2017-02-19
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Gelineau, H. Ralph
Jean Brackoneski
B: 1935-02-17
D: 2017-02-09
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Brackoneski, Jean
Henry Putala
B: 1925-02-21
D: 2017-02-02
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Putala, Henry
Alan Hefflon
B: 1935-12-21
D: 2017-01-28
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Hefflon, Alan
Rowena Szoka
B: 1931-04-18
D: 2017-01-22
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Szoka, Rowena

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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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