Obituaries

ROY SIMMONS
B: 1943-11-01
D: 2018-01-13
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SIMMONS, ROY
ROBERT WILLIAMS
B: 1956-04-21
D: 2018-01-12
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WILLIAMS, ROBERT
KEVIN GARRETT
B: 1963-10-01
D: 2018-01-12
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GARRETT, KEVIN
LACY SMITH
B: 1962-01-09
D: 2018-01-10
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SMITH, LACY
Elizabeth Boynton-Snyder
B: 1973-04-08
D: 2018-01-06
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Boynton-Snyder, Elizabeth
Nicole Duckson
B: 1983-01-23
D: 2018-01-05
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Duckson, Nicole
Kristina Duckson-Garrett
B: 2013-09-18
D: 2018-01-05
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Duckson-Garrett, Kristina
GEORGE THOMPSON
B: 1930-02-01
D: 2018-01-03
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THOMPSON, GEORGE
JAMES HAYNES
B: 1931-07-30
D: 2017-12-31
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HAYNES, JAMES
Grace Hill
B: 1928-07-01
D: 2017-12-30
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Hill, Grace
Roxie Turner
B: 1968-02-22
D: 2017-12-28
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Turner, Roxie
Betty Spencer
B: 1937-11-28
D: 2017-12-27
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Spencer, Betty
ADRIAN JAMES
B: 1929-10-06
D: 2017-12-27
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JAMES, ADRIAN
ANTHONY HILL
B: 1951-02-11
D: 2017-12-25
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HILL, ANTHONY
Damisha Hobbs-Anderson
B: 1983-03-25
D: 2017-12-25
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Hobbs-Anderson, Damisha
Gladys Clark
B: 1919-03-13
D: 2017-12-23
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Clark, Gladys
Emma Ridley
B: 1917-12-17
D: 2017-12-22
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Ridley, Emma
WILLIAM SAMUELS
B: 1944-11-09
D: 2017-12-17
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SAMUELS, WILLIAM
KEVIN GIBSON
B: 1967-05-29
D: 2017-12-16
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GIBSON, KEVIN
BRANDON BRIDGES
B: 1986-04-06
D: 2017-12-10
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BRIDGES, BRANDON
Patricia Lipsey
B: 1960-02-19
D: 2017-12-05
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Lipsey, Patricia

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3700 Refugee Rd
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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