Obituaries

Elbert Hays
B: 1931-06-19
D: 2021-06-19
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Hays, Elbert
Senniah Saddler
B: 1995-01-11
D: 2021-06-10
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Saddler, Senniah
Bernice Washington
B: 1925-05-06
D: 2021-05-31
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Washington, Bernice
Bernard Liddell
B: 1949-12-28
D: 2021-05-25
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Liddell, Bernard
Charles Ricks
B: 1932-03-18
D: 2021-05-25
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Ricks, Charles
Wandra Root
B: 1947-11-10
D: 2021-05-23
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Root, Wandra
Patricia Wilfong
B: 1946-05-09
D: 2021-05-22
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Wilfong, Patricia
Carolyn Talton
B: 1945-10-06
D: 2021-05-16
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Talton, Carolyn
Sandra Valentine Thompkins
B: 1942-02-07
D: 2021-05-14
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Valentine Thompkins, Sandra
DeAndre Howard
B: 1965-08-15
D: 2021-05-04
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Howard, DeAndre
Peter DeBeers
B: 1945-08-06
D: 2021-05-01
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DeBeers, Peter
Gem Harrison
B: 1973-09-13
D: 2021-04-25
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Harrison, Gem
Cristina Grahl
B: 1949-07-22
D: 2021-04-24
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Grahl, Cristina
Kathy Grigsby
B: 1959-05-18
D: 2021-04-22
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Grigsby, Kathy
Kip Watson
B: 1978-03-11
D: 2021-04-22
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Watson, Kip
Cynthia Hampton- Green
B: 1950-03-26
D: 2021-04-17
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Hampton- Green, Cynthia
Wilbert Preyer
B: 1973-07-03
D: 2021-04-16
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Preyer, Wilbert
Darrell Towler
B: 1958-09-15
D: 2021-04-14
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Towler, Darrell
Addie Tomlin
B: 1931-08-15
D: 2021-04-10
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Tomlin, Addie
Joanne Eubanks
B: 1980-02-21
D: 2021-04-01
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Eubanks, Joanne
Martha Bonner
B: 1958-12-04
D: 2021-04-01
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Bonner, Martha

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Phone: 626-798-8941
Fax: 626-798-0195

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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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Please place my information on file


 

 

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