Obituaries

Tilvon Mitchell
B: 1956-09-01
D: 2017-07-15
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Mitchell, Tilvon
KANYE CHAMPELLE
B: 2004-08-24
D: 2017-07-12
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CHAMPELLE, KANYE
CURTIS MOCK
B: 1974-05-10
D: 2017-07-12
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MOCK, CURTIS
Rocene Jackson
B: 1945-08-16
D: 2017-07-07
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Jackson, Rocene
Margretta Thomas
B: 1953-12-04
D: 2017-07-06
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Thomas, Margretta
KEVIN WATSON
B: 1960-02-10
D: 2017-07-05
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WATSON, KEVIN
PERCY RAGLAND
B: 1929-01-21
D: 2017-07-05
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RAGLAND, PERCY
Rita Morton
B: 1951-08-11
D: 2017-07-03
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Morton, Rita
Laura McBride
B: 1941-08-05
D: 2017-06-28
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McBride, Laura
EARLY SIMS
B: 1936-08-02
D: 2017-06-19
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SIMS, EARLY
Mackenzie Mayle
B: 2011-06-08
D: 2017-06-16
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Mayle, Mackenzie
Belinda Walls
B: 1951-08-05
D: 2017-06-13
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Walls, Belinda
Kenover Vance
B: 1982-07-30
D: 2017-06-11
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Vance, Kenover
IRA CAMPBELL
B: 1934-12-05
D: 2017-06-07
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CAMPBELL, IRA
Dan-ita Gunnell
B: 1968-09-06
D: 2017-06-05
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Gunnell, Dan-ita
Love Gamble
B: 1950-08-28
D: 2017-06-04
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Gamble, Love
Hope Lewis
B: 1970-04-11
D: 2017-06-03
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Lewis, Hope
VICTOR WOODSON
B: 1960-08-25
D: 2017-06-03
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WOODSON, VICTOR
CARL LATHAM
B: 1947-08-28
D: 2017-06-01
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LATHAM, CARL
JAMES HOLLEY
B: 1950-11-15
D: 2017-05-31
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HOLLEY, JAMES
PAUL LEWIS
B: 1954-01-27
D: 2017-05-30
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LEWIS, PAUL

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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

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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