Obituaries

Mabel Ruffin
B: 1931-02-06
D: 2018-11-04
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Ruffin, Mabel
LEON LOFTON
B: 1947-11-27
D: 2018-11-02
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LOFTON, LEON
LINCOLN COLLINS
B: 1970-07-31
D: 2018-10-25
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COLLINS, LINCOLN
CHARLIE "CHARLES" GOGGANS
B: 1938-08-20
D: 2018-10-22
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GOGGANS, CHARLIE "CHARLES"
WESLEY HAMPTON
B: 1977-03-09
D: 2018-10-22
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HAMPTON, WESLEY
ERNEST BURRESS
B: 1942-10-19
D: 2018-10-21
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BURRESS, ERNEST
DWIGHT CURTIS
B: 1946-05-13
D: 2018-10-21
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CURTIS, DWIGHT
Chandra Johnson
B: 1963-12-29
D: 2018-10-18
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Johnson, Chandra
BENNIE LEWIS
B: 1958-07-27
D: 2018-10-15
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LEWIS, BENNIE
Filocia Dort
B: 1942-12-14
D: 2018-10-10
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Dort, Filocia
TEDDY AUSTIN
B: 1961-10-23
D: 2018-10-07
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AUSTIN, TEDDY
GARY UNDERWOOD-BROWN
B: 1952-02-16
D: 2018-10-04
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UNDERWOOD-BROWN, GARY
Janelle Jackson
B: 1993-07-03
D: 2018-10-03
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Jackson, Janelle
Lavonne Walters
B: 1950-09-04
D: 2018-10-01
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Walters, Lavonne
ANTONIO GIVENS
B: 1967-09-05
D: 2018-09-29
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GIVENS, ANTONIO
AUGUSTUS HOWARD
B: 1945-01-19
D: 2018-09-28
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HOWARD, AUGUSTUS
CLARENCE PAYNE
B: 1937-05-15
D: 2018-09-25
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PAYNE, CLARENCE
CURTIS LEE
B: 1970-04-06
D: 2018-09-24
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LEE, CURTIS
Rhoda Henderson
B: 1939-09-11
D: 2018-09-24
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Henderson, Rhoda
KEITH BOSLEY
B: 1962-01-16
D: 2018-09-23
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BOSLEY, KEITH
Juanita Hayes
B: 1929-06-02
D: 2018-09-21
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Hayes, Juanita

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Columbus, OH 43232
Phone: 614-338-1965
Fax: 614-338-4287

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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

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Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
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Outer Container Preference: (for ground burial)
Cemetery Name:
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The cemetery property is in the name of:

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