Obituaries

Peggy Hazelwood
B: 1940-10-10
D: 2025-05-26
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Hazelwood, Peggy
Donald Sellars
B: 1945-12-06
D: 2025-05-26
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Sellars, Donald
Henry Millward
B: 1956-09-16
D: 2025-05-25
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Millward, Henry
Lila Davis
B: 1946-08-04
D: 2025-05-22
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Davis, Lila
Donald Gotthardt
B: 1936-10-24
D: 2025-05-22
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Gotthardt, Donald
Danny Rice
B: 1947-12-30
D: 2025-05-21
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Rice, Danny
Carolyn King
B: 1943-12-15
D: 2025-05-15
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King, Carolyn
Frances Packett
B: 1939-01-17
D: 2025-05-12
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Packett, Frances
Margaret Self
B: 1935-05-04
D: 2025-05-12
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Self, Margaret
Wayne Lawson
B: 1944-10-13
D: 2025-05-12
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Lawson, Wayne
Charles Bertrand
B: 1952-08-10
D: 2025-05-11
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Bertrand, Charles
Maisie Sisson
B: 1929-04-22
D: 2025-05-08
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Sisson, Maisie
Joyce Northern
B: 1943-03-13
D: 2025-05-01
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Northern, Joyce
Byrd Newton
B: 1943-12-05
D: 2025-04-28
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Newton, Byrd
Alene Hayes
B: 1939-07-06
D: 2025-04-27
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Hayes, Alene
Marion Sanders
B: 1930-11-22
D: 2025-04-27
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Sanders, Marion
William Amon
B: 1934-01-04
D: 2025-04-25
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Amon, William
Ralph Elledge
B: 1948-05-05
D: 2025-04-24
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Elledge, Ralph
Robert Newsome
B: 1936-05-14
D: 2025-04-23
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Newsome, Robert
Lawrence Jett
B: 1944-05-02
D: 2025-04-23
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Jett, Lawrence
Stephen Doljac
B: 1952-01-12
D: 2025-04-22
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Doljac, Stephen

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

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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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