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

John “Adam” Fletcher

Joyce Ann (Adams) McReynolds

Karen Denise (Raley) Loar

Billy “Bill” Kennett

Doris Jane (Hardin) Bey

Micah Russell Merryman-Scifres

Gary Roger Meggs, Sr

Marjorie L. Motter

Corey Lee Robinson

Jeffrey (Jeff, JR) Price Richardson

Rhonda Sue Thomas Jackson

Francis Earl Murray