Obituaries

Loretta Valtri
B: 1939-08-19
D: 2018-05-17
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Valtri, Loretta
Sara Johns
B: 1926-11-27
D: 2018-05-14
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Johns, Sara
Hugh Zinsmeister
B: 1934-01-02
D: 2018-05-10
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Zinsmeister, Hugh
Winifred Seby
B: 1920-10-13
D: 2018-05-08
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Seby, Winifred
Jay Ream
B: 1925-03-02
D: 2018-05-07
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Ream, Jay
John Lindsey
B: 1941-09-11
D: 2018-05-06
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Lindsey, John
Vaughn Yeater
B: 1944-04-13
D: 2018-05-03
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Yeater, Vaughn
Carey Harpster
B: 1936-04-19
D: 2018-05-03
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Harpster, Carey
Donald Pennington
B: 1939-11-12
D: 2018-05-01
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Pennington, Donald
Sandra Bender
B: 1960-06-03
D: 2018-04-28
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Bender, Sandra
Alice Schnure
D: 2018-04-27
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Schnure, Alice
Regina Zagurskie
B: 1952-10-13
D: 2018-04-25
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Zagurskie, Regina
Thomas Wagner
B: 1954-06-19
D: 2018-04-21
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Wagner, Thomas
Michael Drozda
B: 1924-05-21
D: 2018-04-18
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Drozda, Michael
Amy Stetler
B: 1982-06-25
D: 2018-04-18
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Stetler, Amy
Frederick Grassmyer
B: 1941-08-02
D: 2018-04-17
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Grassmyer, Frederick
Frederick Grassmyer
B: 1941-08-02
D: 2018-04-17
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Grassmyer, Frederick
Elaine McCaffrey
B: 1945-12-11
D: 2018-04-17
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McCaffrey, Elaine
Peggy Botteicher
B: 1931-05-24
D: 2018-04-16
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Botteicher, Peggy
Vivian Getz
B: 1930-01-19
D: 2018-04-16
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Getz, Vivian
Richard Parker
B: 1951-01-04
D: 2018-04-06
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Parker, Richard

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Lewistown, PA 17044
Phone: 717-248-5486
Fax: 717-248-2277

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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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