Obituaries

Gail Crook
B: 1957-06-23
D: 2025-04-17
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Crook, Gail
Newbill Conley
B: 1949-12-02
D: 2025-04-14
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Conley, Newbill
Maytrus Self
B: 1936-09-13
D: 2025-04-10
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Self, Maytrus
Alice Herbert
B: 1942-10-20
D: 2025-04-09
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Herbert, Alice
Darrell Woolard
B: 1931-09-17
D: 2025-04-07
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Woolard, Darrell
Joseph Harley
B: 1935-09-29
D: 2025-04-07
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Harley, Joseph
Mark Wiseman
B: 1960-02-24
D: 2025-04-06
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Wiseman, Mark
Samuel Pittman
B: 1932-09-13
D: 2025-04-04
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Pittman, Samuel
Blanche Dameron
B: 1923-10-20
D: 2025-04-02
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Dameron, Blanche
James Hood
B: 1946-03-23
D: 2025-04-02
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Hood, James
Harijs Palka
B: 1936-10-04
D: 2025-04-02
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Palka, Harijs
Gloria Burgess
B: 1952-09-02
D: 2025-03-31
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Burgess, Gloria
Joan Balderson
B: 1941-01-31
D: 2025-03-31
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Balderson, Joan
Dewey Schools
B: 1963-02-18
D: 2025-03-30
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Schools, Dewey
Paul Compton
B: 1962-08-02
D: 2025-03-28
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Compton, Paul
Kemper Garner
B: 1940-08-15
D: 2025-03-28
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Garner, Kemper
Colleen Rowland
B: 1937-09-30
D: 2025-03-25
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Rowland, Colleen
Garnett Horner
B: 1935-04-29
D: 2025-03-25
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Horner, Garnett
Catherine Carden
B: 1968-10-04
D: 2025-03-25
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Carden, Catherine
Katherine Sanford
B: 1940-05-30
D: 2025-03-24
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Sanford, Katherine
Robbie France
B: 1963-05-06
D: 2025-03-24
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France, Robbie

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10300 Richmond Road
Warsaw, VA 22572
Phone: 804-333-3770
Fax: 804-333-0079

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Immediate Need


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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Please place my information on file