Vital Statistics Form

Please fill this form out as much as possible. It will help us to complete the death certificate and in writing the obituary. All fields with an asterisk are required.

Deceased's Information

If residence, please include address
mm/dd/yyyy
English, Irish, French, German, etc.
Be specific
Primary occupation during working years. *Do not enter \"retired\".
Sales, Medical, Engineering, Construction, etc.
Please list survivors and relationship: son, daughter, brother, sister, etc.
Religious affiliations, fraternal and civic organizations, hobbies, etc.

Informant's Information

A copy of what is submitted will be sent to this email.
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Obituaries & Condolences

Stanley F. Nasalik

Elmer J. (Joe) Wisecarver

Andria Marie Kragnes

Robert Almy Kipp

Raymond J. Golik

Roberta “Bobbi” Diaz

Martha J. Alexander (Embree) Reffett

Genevieve Harrell Hauck

Tricia Ann Jackson

Susan Gail Creath-Robinson

Billie Beth (Pence) Lourie

Thomas “Tom” Edward Oxley, Sr.