Obituaries

David Caldwell
B: 1954-01-31
D: 2019-08-16
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Caldwell, David
Johnnie Gray
B: 1957-09-05
D: 2019-08-14
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Gray, Johnnie
Marvin “Gene” Walker
B: 1935-06-13
D: 2019-08-13
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Walker, Marvin “Gene”
Ronney Porter
B: 1974-02-13
D: 2019-08-12
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Porter, Ronney
Ben Thomas
B: 1988-05-08
D: 2019-08-09
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Thomas, Ben
Rachel Fullem
B: 1922-03-07
D: 2019-08-08
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Fullem, Rachel
Virginia Ingle
B: 1924-10-06
D: 2019-08-08
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Ingle, Virginia
Jerry Fox
B: 1937-12-19
D: 2019-08-06
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Fox, Jerry
Benjamin Flowe
B: 1926-07-20
D: 2019-07-31
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Flowe, Benjamin
Katelyn Hagler
B: 1999-12-27
D: 2019-07-30
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Hagler, Katelyn
Lana Dalton
B: 1947-01-23
D: 2019-07-29
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Dalton, Lana
Clifford Rimer
B: 1931-01-30
D: 2019-07-26
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Rimer, Clifford
Michell Black
B: 1963-07-20
D: 2019-07-25
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Black, Michell
Jane Morrison Harris Nierenberg
D: 2019-07-23
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Harris Nierenberg, Jane Morrison
Lewis Thomas
B: 1931-02-16
D: 2019-07-21
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Thomas, Lewis
Leanne Powell
B: 1968-06-30
D: 2019-07-20
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Powell, Leanne
Margaret Miller
B: 1923-11-05
D: 2019-07-19
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Miller, Margaret
William Patrick
B: 1946-05-01
D: 2019-07-18
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Patrick, William
Victor Montgomery
B: 1965-09-21
D: 2019-07-14
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Montgomery, Victor
Jake Critz
B: 1981-03-21
D: 2019-07-14
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Critz, Jake
Charles Norris
B: 1953-02-04
D: 2019-07-13
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Norris, Charles

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100 Branchview Drive NE
PO Box 344
Concord, NC 28025
Phone: 704-786-3168
Fax: 704-782-5766

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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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