Obituaries

Elizabeth Drake
B: 1931-04-24
D: 2023-09-28
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Drake, Elizabeth
Arlene Jensen
B: 1935-12-13
D: 2023-09-27
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Jensen, Arlene
Theresa Molyneux
B: 1944-04-10
D: 2023-09-26
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Molyneux, Theresa
Robert Elliott
B: 1936-08-22
D: 2023-09-25
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Elliott, Robert
Richard MacLachlan
B: 1942-04-18
D: 2023-09-24
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MacLachlan, Richard
Jason Ellsworth
B: 1976-04-03
D: 2023-09-22
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Ellsworth, Jason
Edward O'Brien
B: 1942-10-30
D: 2023-09-20
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O'Brien, Edward
Pamela Fortuna
B: 1963-10-05
D: 2023-09-17
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Fortuna, Pamela
Brenda Neron
B: 1945-05-14
D: 2023-09-17
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Neron, Brenda
Gloria Giammarino
B: 1951-09-25
D: 2023-09-15
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Giammarino, Gloria
Elizabeth Skolnick
B: 1940-03-19
D: 2023-09-10
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Skolnick, Elizabeth
Ronald Marks
B: 1951-05-25
D: 2023-09-06
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Marks, Ronald
Larry Barbo
B: 1955-04-09
D: 2023-09-06
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Barbo, Larry
Richard McLaughlin
B: 1959-06-10
D: 2023-09-06
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McLaughlin, Richard
Helen Taylor
B: 1932-06-19
D: 2023-09-03
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Taylor, Helen
Donna Armstrong
B: 1957-07-01
D: 2023-09-03
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Armstrong, Donna
Burnham Thompson
B: 1939-05-11
D: 2023-08-31
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Thompson, Burnham
John Thompson
B: 1960-06-28
D: 2023-08-26
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Thompson, John
Violet McLaughlin
B: 1937-06-22
D: 2023-08-25
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McLaughlin, Violet
Ann Marie Hakian
B: 1940-10-19
D: 2023-08-25
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Hakian, Ann Marie
Thomas Keaveney
B: 1938-07-10
D: 2023-08-25
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Keaveney, Thomas

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Phone: (860) 875-5490
Fax: (860) 872-8200

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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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