Obituaries

Mary Ann Lee
B: 1932-07-04
D: 2024-09-26
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Lee, Mary Ann
James McGrew
B: 1931-12-25
D: 2024-09-12
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McGrew, James
Gwendolyn Watson
B: 1958-11-25
D: 2024-09-11
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Watson, Gwendolyn
Suzanne Fream
D: 2024-09-09
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Fream, Suzanne
Carlos Revilla
D: 2024-09-06
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Revilla, Carlos
Patricia Selim
B: 1935-12-28
D: 2024-09-03
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Selim, Patricia
Patricia Selim
B: 1935-12-28
D: 2024-09-03
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Selim, Patricia
Norma Albert
D: 2024-09-02
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Albert, Norma
Charlene Flickinger
B: 1958-10-29
D: 2024-08-29
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Flickinger, Charlene
Joyce Eppolito
B: 1935-07-04
D: 2024-08-22
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Eppolito, Joyce
Wolfgang Boettcher
B: 1936-02-28
D: 2024-08-19
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Boettcher, Wolfgang
Lois White
B: 1930-06-30
D: 2024-08-05
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White, Lois
Judith Welborn
B: 1940-10-07
D: 2024-08-02
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Welborn, Judith
Jeanne Levesque
B: 1927-09-28
D: 2024-07-25
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Levesque, Jeanne
Chandrakant Patel
B: 1962-06-24
D: 2024-07-11
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Patel, Chandrakant
Nelya Rekun
B: 1938-01-29
D: 2024-07-04
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Rekun, Nelya
Martha Hatley
B: 1931-05-14
D: 2024-07-02
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Hatley, Martha
William Hinebaugh
B: 1945-02-28
D: 2024-06-18
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Hinebaugh, William
Merle Warren
B: 1944-09-21
D: 2024-06-13
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Warren, Merle
Willena Dixon
B: 1955-11-03
D: 2024-06-13
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Dixon, Willena
Rosetta Mannino
D: 2024-06-03
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Mannino, Rosetta

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Phone: (386) 253-7601
Fax: (386) 253-7647

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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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