Obituaries

Lillianne Clavet
B: 1935-10-12
D: 2025-03-04
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Clavet, Lillianne
Robert Hiller
B: 1936-12-21
D: 2025-02-25
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Hiller, Robert
Barbara Helm
B: 1941-12-26
D: 2025-02-25
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Helm, Barbara
Marty Coles
B: 1957-12-20
D: 2025-02-25
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Coles, Marty
Gilbert Connly
B: 1936-01-31
D: 2025-02-24
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Connly, Gilbert
Patricia Dimock
B: 1941-10-05
D: 2025-02-21
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Dimock, Patricia
Jeffrey Benis
B: 1969-08-15
D: 2025-02-18
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Benis, Jeffrey
Charles Thompson
B: 1956-01-25
D: 2025-02-18
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Thompson, Charles
Duane Matthews
B: 1937-00-00
D: 2025-02-16
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Matthews, Duane
Elizabeth Reynolds
B: 1934-05-10
D: 2025-02-16
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Reynolds, Elizabeth
Geraldine Hoboth
B: 1942-01-15
D: 2025-02-15
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Hoboth, Geraldine
Michael Kane
B: 1945-03-24
D: 2025-02-15
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Kane, Michael
Anthony Bailey
B: 1986-02-07
D: 2025-02-15
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Bailey, Anthony
June Currier
B: 1949-09-08
D: 2025-02-11
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Currier, June
Eric Timrud
B: 1945-01-07
D: 2025-02-10
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Timrud, Eric
Charles Murphy
B: 1950-11-25
D: 2025-02-09
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Murphy, Charles
Rudolph Valentino
B: 1932-11-05
D: 2025-02-07
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Valentino, Rudolph
Rose Bashaw
B: 1938-10-21
D: 2025-02-05
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Bashaw, Rose
Robert Nedjoika
B: 1947-08-04
D: 2025-02-02
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Nedjoika, Robert
Tammy Kennedy
B: 1960-07-05
D: 2025-02-01
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Kennedy, Tammy
Real Cloutier
B: 1943-07-02
D: 2025-01-31
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Cloutier, Real

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Rockville-Vernon, CT 06066
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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