Obituaries

Guy Farrar
B: 1920-09-16
D: 2017-04-25
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Farrar, Guy
Josee Deltenre
B: 1923-07-14
D: 2017-04-19
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Deltenre, Josee
Richard Caserta
B: 1933-08-28
D: 2017-04-18
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Caserta, Richard
Halina Siarkowski
B: 1940-07-12
D: 2017-04-18
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Siarkowski, Halina
George McCarron
B: 1937-05-31
D: 2017-04-17
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McCarron, George
Alison Soderberg
B: 1951-10-17
D: 2017-04-16
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Soderberg, Alison
Edward Storrs
B: 1933-02-15
D: 2017-04-16
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Storrs, Edward
Robert Bittens
D: 2017-04-15
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Bittens, Robert
Richard D. Vogler
B: 1946-09-30
D: 2017-04-12
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Vogler, Richard D.
Glenn DeVoe
B: 1963-02-12
D: 2017-04-12
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DeVoe, Glenn
Janet Dandley
B: 1935-11-05
D: 2017-04-11
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Dandley, Janet
Frank Croce
B: 1935-12-05
D: 2017-04-10
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Croce, Frank
John Molstad
B: 1932-04-12
D: 2017-04-09
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Molstad, John
Alfred Pandolfo
B: 1949-03-01
D: 2017-04-05
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Pandolfo, Alfred
Grace McFarland
B: 1925-09-29
D: 2017-04-01
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McFarland, Grace
Ethel Green
B: 1937-04-23
D: 2017-03-30
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Green, Ethel
Robert Dyer
B: 1955-11-03
D: 2017-03-26
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Dyer, Robert
Michael Shaskus
B: 1963-06-03
D: 2017-03-22
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Shaskus, Michael
Carolyn Huff
B: 1942-11-13
D: 2017-03-20
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Huff, Carolyn
William O'Connor
B: 1930-12-15
D: 2017-03-20
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O'Connor, William
Anne Lewis
D: 2017-03-18
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Lewis, Anne

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Simsbury, CT 06070
Phone: 860-658-7613
Fax: 860-651-0476

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I. Biographical Information

Full Name:
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 You In Death
Your 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

         
       

 

 

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