Obituaries

Juanita Jones
B: 1924-10-22
D: 2019-04-20
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Jones, Juanita
Shirley George
B: 1952-10-29
D: 2019-04-20
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George, Shirley
David Tillman
B: 1943-01-05
D: 2019-04-13
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Tillman, David
Mellise Brown
B: 1925-01-19
D: 2019-04-12
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Brown, Mellise
Samuel Crosby
B: 1945-06-13
D: 2019-04-07
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Crosby, Samuel
Hillard Hill
B: 1936-08-15
D: 2019-04-06
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Hill, Hillard
Frankie Washington
B: 1931-07-02
D: 2019-04-03
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Washington, Frankie
Lee Jordan
B: 1939-01-14
D: 2019-04-02
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Jordan, Lee
Isaiah Velez
B: 2011-06-18
D: 2019-03-29
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Velez, Isaiah
Harold Reese
B: 1952-08-18
D: 2019-03-26
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Reese, Harold
Arthur Hawkins
B: 1923-07-08
D: 2019-03-22
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Hawkins, Arthur
Otis Knox
B: 1935-10-07
D: 2019-03-22
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Knox, Otis
Stacye Jones
B: 1961-12-06
D: 2019-03-21
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Jones, Stacye
Frank Hicks
B: 1940-05-28
D: 2019-03-02
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Hicks, Frank
Holly Lewis
B: 1958-01-12
D: 2019-03-01
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Lewis, Holly
Rosie Daniels
B: 1925-10-27
D: 2019-02-28
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Daniels, Rosie
Virginia Anderson
B: 1987-12-25
D: 2019-02-27
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Anderson, Virginia
Parilee Smith
B: 1923-09-19
D: 2019-02-27
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Smith, Parilee
Louise Brown
B: 1922-03-04
D: 2019-02-19
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Brown, Louise
Barbara Robinson
B: 1933-01-06
D: 2019-02-17
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Robinson, Barbara
Charles Ralls
B: 1962-10-26
D: 2019-02-13
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Ralls, Charles

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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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