Obituaries

Donavan Axtell
B: 1930-06-30
D: 2018-04-16
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Axtell, Donavan
Thomas Ratchford
B: 1936-11-25
D: 2018-04-10
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Ratchford, Thomas
Peggy Stevenson
B: 1942-06-24
D: 2018-04-03
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Stevenson, Peggy
Ned Johnson
B: 1957-10-14
D: 2018-03-31
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Johnson, Ned
Martha Neisen
B: 1984-04-12
D: 2018-03-31
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Neisen, Martha
Carol Kelley
B: 1924-05-12
D: 2018-03-30
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Kelley, Carol
Thomas McNamara
B: 1937-09-30
D: 2018-03-20
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McNamara, Thomas
Rita Ridder
B: 1951-12-02
D: 2018-03-15
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Ridder, Rita
Margaret Croal
B: 1935-07-28
D: 2018-03-03
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Croal, Margaret
Deleva Platt
B: 1932-06-16
D: 2018-03-03
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Platt, Deleva
Edwin Skripsky
D: 2018-02-28
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Skripsky, Edwin
Elva Prenosil
B: 1918-07-20
D: 2018-02-27
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Prenosil, Elva
Mildred Potts
B: 1924-08-05
D: 2018-02-21
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Potts, Mildred
Orlie Rawson
B: 1939-10-07
D: 2018-02-18
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Rawson, Orlie
Louis Fischels
B: 1929-11-20
D: 2018-02-17
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Fischels, Louis
Virginia Sleeper
B: 1938-07-28
D: 2018-02-15
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Sleeper, Virginia
Henry Snyder
B: 1938-03-05
D: 2018-02-13
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Snyder, Henry
Barbara Smith
B: 1934-04-27
D: 2018-02-13
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Smith, Barbara
Thomas O'Connell
B: 1953-12-31
D: 2018-01-28
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O'Connell, Thomas
Alice Kelley
B: 1921-03-22
D: 2018-01-24
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Kelley, Alice
Donald Boies
B: 1926-09-11
D: 2018-01-03
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Boies, Donald

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216 3rd Ave. SE.
Independence, IA 50644
Phone: (319) 334-2501
Fax: (319) 334-2502

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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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