Obituaries

John Hurt
B: 1931-08-09
D: 2017-06-22
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Hurt, John
Flora Williams
B: 1946-10-07
D: 2017-06-18
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Williams, Flora
Ethel Duncan
B: 1931-06-16
D: 2017-06-13
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Duncan, Ethel
Johnnie Greer
B: 1952-06-15
D: 2017-06-13
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Greer, Johnnie
Marsha Newberry-Jones
B: 1952-08-14
D: 2017-06-10
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Newberry-Jones, Marsha
Ricky Thomas
B: 1958-03-12
D: 2017-06-09
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Thomas, Ricky
Clyde Greggs
B: 1936-11-24
D: 2017-06-07
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Greggs, Clyde
Melvin Adams
B: 1951-03-01
D: 2017-06-06
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Adams, Melvin
Paul Rener
B: 1941-01-28
D: 2017-06-06
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Rener, Paul
Sandra Henry
B: 1954-12-23
D: 2017-06-05
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Henry, Sandra
Alice Brown
B: 1944-02-24
D: 2017-06-02
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Brown, Alice
Bessie Harris
B: 1922-10-02
D: 2017-05-30
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Harris, Bessie
Dr.Earl Perry
B: 1937-02-04
D: 2017-05-24
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Perry, Dr.Earl
Anita Parnell
B: 1941-03-01
D: 2017-05-22
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Parnell, Anita
Anita Parnell
B: 1941-03-01
D: 2017-05-22
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Parnell, Anita
Paul Glascow
B: 1938-09-15
D: 2017-05-19
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Glascow, Paul
Fred Valentine
B: 1919-01-22
D: 2017-05-13
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Valentine, Fred
JoeAnn Vaughns
B: 1961-04-14
D: 2017-05-13
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Vaughns, JoeAnn
Fred Valentine
B: 1919-01-22
D: 2017-05-13
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Valentine, Fred
Joe Ann Vaughns
B: 1961-04-14
D: 2017-05-13
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Vaughns, Joe Ann
Albert Penn
B: 1938-05-08
D: 2017-05-10
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Penn, Albert

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Phone: 626-798-8941
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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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