Obituaries

Eddie Epperson
D: 2014-04-04
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Epperson, Eddie
Jettie Hurt
B: 1948-10-04
D: 2014-03-23
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Hurt, Jettie
Winter Hayes
B: 1940-01-13
D: 2014-03-20
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Hayes, Winter
Phyllis Tims
B: 1959-02-02
D: 2014-03-19
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Tims, Phyllis
Hardis Sullivan
B: 1955-07-24
D: 2014-03-17
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Sullivan, Hardis
Jamie Williams
B: 1979-01-17
D: 2014-03-15
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Williams, Jamie
Norma Word
B: 1939-11-18
D: 2014-03-12
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Word, Norma
Kimberly Campbell
B: 1988-01-27
D: 2014-03-11
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Campbell, Kimberly
Flora Moore
B: 1946-11-12
D: 2014-02-22
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Moore, Flora
Henry Banks
B: 1935-01-13
D: 2014-02-18
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Banks, Henry
Ernestine Smith
B: 1926-10-31
D: 2014-02-18
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Smith, Ernestine
Edgar Moore
B: 1927-03-02
D: 2014-02-14
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Moore, Edgar
Willie Yarbrough
B: 1965-04-23
D: 2014-02-11
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Yarbrough, Willie
George Jordan
B: 1959-01-30
D: 2014-02-09
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Jordan, George
Leroy Champion
B: 1927-10-23
D: 2014-02-07
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Champion, Leroy
Alice Shutes
B: 1948-05-08
D: 2014-02-07
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Shutes, Alice
Connie Herron
B: 1939-03-18
D: 2014-02-04
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Herron, Connie
Hattie Miller
B: 1923-08-11
D: 2014-02-01
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Miller, Hattie
Jerry Lloyd
B: 1943-11-27
D: 2014-01-28
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Lloyd, Jerry
Annie Davis
B: 1949-05-27
D: 2014-01-27
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Davis, Annie
Calvin Mays
B: 1951-08-28
D: 2014-01-27
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Mays, Calvin

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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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