Obituaries

Charles Brothers
B: 1929-10-27
D: 2020-07-07
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Brothers, Charles
Gregg Clugston
B: 1946-10-18
D: 2020-07-06
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Clugston, Gregg
Geraldine Lyter
B: 1922-07-25
D: 2020-07-03
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Lyter, Geraldine
Roy Colyer
B: 1940-01-05
D: 2020-06-22
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Colyer, Roy
Winifred Flickinger
B: 1923-03-15
D: 2020-06-20
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Flickinger, Winifred
James Gibbons
B: 1929-12-25
D: 2020-06-18
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Gibbons, James
Shirley Weller
B: 1932-03-13
D: 2020-06-02
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Weller, Shirley
Joseph Brown
B: 1935-06-24
D: 2020-05-25
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Brown, Joseph
Curtis Kint
B: 1957-01-23
D: 2020-05-25
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Kint, Curtis
James Doughten
B: 1930-01-05
D: 2020-05-23
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Doughten, James
Dianne Detra
B: 1951-09-17
D: 2020-05-22
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Detra, Dianne
Robert Cameron
B: 1929-08-26
D: 2020-05-19
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Cameron, Robert
Patricia Stitt
B: 1930-08-20
D: 2020-05-18
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Stitt, Patricia
Philip Yeater
B: 1944-11-28
D: 2020-05-18
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Yeater, Philip
Gene Horton
B: 1930-05-15
D: 2020-05-14
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Horton, Gene
Patricia Leister
B: 1959-01-13
D: 2020-05-13
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Leister, Patricia
Ida Wagner
B: 1930-12-11
D: 2020-05-11
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Wagner, Ida
Wayne Sieber
B: 1960-06-04
D: 2020-05-10
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Sieber, Wayne
Luella Mahlin
B: 1927-09-10
D: 2020-05-10
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Mahlin, Luella
David Llewellyn
B: 1938-08-07
D: 2020-05-07
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Llewellyn, David
Roberta Ellis
B: 1936-02-13
D: 2020-05-06
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Ellis, Roberta

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Mifflintown, PA 17059
Phone: 717-436-6252
Fax: 717-436-6912

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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:
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Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

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