Obituaries

Brianna Mailloux
B: 2000-10-19
D: 2018-04-19
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Mailloux, Brianna
Barbara Leone
B: 1936-01-03
D: 2018-04-13
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Leone, Barbara
Paul Pacewicz
B: 1928-06-29
D: 2018-03-22
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Pacewicz, Paul
Robert Hinckley
B: 1935-04-30
D: 2018-03-12
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Hinckley , Robert
Janet Devin
B: 1932-10-12
D: 2018-02-23
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Devin, Janet
Florence Miarecki
B: 1923-10-09
D: 2018-02-19
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Miarecki, Florence
Joseph Phillips
B: 1925-03-19
D: 2018-02-05
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Phillips, Joseph
Margot Winkler
B: 1930-06-10
D: 2018-02-04
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Winkler, Margot
Jerrold Camp
B: 1937-05-28
D: 2018-01-28
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Camp, Jerrold
William Carney
B: 1965-04-09
D: 2018-01-19
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Carney, William
Robert Hamel
B: 1916-01-23
D: 2017-12-29
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Hamel, Robert
Robert Wilson
B: 1960-08-26
D: 2017-12-27
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Wilson, Robert
Florence Brunton Gleba
B: 1931-03-04
D: 2017-12-03
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Brunton Gleba, Florence
Ronald Wozniak
B: 1945-02-25
D: 2017-11-30
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Wozniak, Ronald
Stephen Knoop
B: 1941-02-12
D: 2017-10-21
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Knoop, Stephen
Donald Osowiecki
B: 1973-04-05
D: 2017-10-10
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Osowiecki, Donald
Bonnie Carney
B: 1943-03-02
D: 2017-09-08
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Carney, Bonnie
Albert Lancioni
B: 1921-05-07
D: 2017-09-06
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Lancioni, Albert
Annie Reay
B: 1927-05-10
D: 2017-09-06
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Reay, Annie
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

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West Suffield, CT 06093-0309
Phone: 860-668-0255
Fax: 860-668-0256

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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:

Miscellaneous Notes and Instructions:

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