Obituaries

Judi Rhoades Smith
B: 1961-11-15
D: 2018-01-22
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Rhoades Smith, Judi
Harold Diedrich
B: 1928-10-14
D: 2018-01-21
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Diedrich, Harold
Neal Demskie
B: 1949-12-23
D: 2018-01-17
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Demskie, Neal
David Hunter
B: 1948-09-15
D: 2018-01-14
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Hunter, David
James Carson
B: 1949-07-02
D: 2018-01-13
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Carson, James
Robert Wray
B: 1927-05-18
D: 2018-01-13
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Wray, Robert
Eugene Bishop
B: 1934-08-22
D: 2018-01-11
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Bishop, Eugene
James Abbott
B: 1926-09-17
D: 2018-01-10
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Abbott, James
Charles Warfel
B: 1927-04-15
D: 2018-01-09
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Warfel, Charles
Andrea Wolfkiel
B: 1949-06-20
D: 2018-01-04
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Wolfkiel, Andrea
Gary Baker
B: 1936-11-09
D: 2018-01-02
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Baker, Gary
Deborah Sauers
B: 1949-04-06
D: 2018-01-01
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Sauers, Deborah
Terry McLucas
B: 1951-04-09
D: 2017-12-31
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McLucas, Terry
Dolly Davis
B: 1940-04-22
D: 2017-12-24
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Davis, Dolly
Judy Grassmyer
B: 1941-08-17
D: 2017-12-21
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Grassmyer, Judy
John Tate
B: 1934-12-31
D: 2017-12-21
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Tate, John
Russell Alexander
B: 1932-06-07
D: 2017-12-13
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Alexander, Russell
LeRoy Black
B: 1926-10-14
D: 2017-12-12
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Black, LeRoy
Barbara Shearer
B: 1933-03-11
D: 2017-12-09
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Shearer, Barbara
Dr. Edward Shore
B: 1931-05-18
D: 2017-12-06
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Shore, Dr. Edward
Nancy Renninger
B: 1938-09-18
D: 2017-11-25
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Renninger, Nancy

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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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