Obituaries

Lewis Payne
B: 1938-08-09
D: 2017-07-20
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Payne, Lewis
Samuel Grimes
B: 1935-12-19
D: 2017-07-17
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Grimes, Samuel
Robert Carothers
B: 1929-10-31
D: 2017-07-15
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Carothers, Robert
Frank Laumann
B: 1943-09-24
D: 2017-07-14
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Laumann, Frank
Thomas Conard
B: 1945-05-15
D: 2017-07-12
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Conard, Thomas
Michael Daniel
B: 1985-08-13
D: 2017-07-10
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Daniel, Michael
Brett Connoley
B: 1982-06-01
D: 2017-07-10
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Connoley, Brett
George Kinyon
B: 1952-09-22
D: 2017-07-09
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Kinyon, George
Carroll Brown
B: 1941-05-02
D: 2017-07-06
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Brown, Carroll
Larry Ivey
B: 1953-02-05
D: 2017-07-03
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Ivey, Larry
Doris Horton
B: 1927-10-14
D: 2017-06-30
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Horton, Doris
Ronald Dinges
B: 1951-11-18
D: 2017-06-30
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Dinges, Ronald
Cyrus Moazed
B: 1934-08-17
D: 2017-06-28
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Moazed, Cyrus
Powell Carter
B: 1931-06-03
D: 2017-06-28
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Carter, Powell
Dorothy Grace
B: 1938-10-18
D: 2017-06-25
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Grace, Dorothy
Joan Freeman
B: 1931-04-03
D: 2017-06-23
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Freeman, Joan
Maria Tishue
B: 1947-07-05
D: 2017-06-16
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Tishue, Maria
Wanda Henson
B: 1956-08-13
D: 2017-06-16
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Henson, Wanda
Lanita Dutcher
B: 2017-06-16
D: 2017-06-16
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Dutcher, Lanita
Cynthia Heilman
B: 1961-01-16
D: 2017-06-14
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Heilman, Cynthia
Wesley Bradford
B: 1951-03-08
D: 2017-06-14
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Bradford, Wesley

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HAGERSTOWN, MD 21740
Phone: (301) 739-5498
Fax: (301) 733-6369

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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:
Person in Charge of Arrangements:
Officiating Clergy:
Flower Preference:
Music Selection:
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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