Obituaries

Katherine Leslie
B: 1949-03-31
D: 2017-06-23
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Leslie, Katherine
Arthur Sies
B: 1946-03-01
D: 2017-06-22
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Sies, Arthur
Christopher Storm
B: 1960-04-10
D: 2017-06-20
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Storm, Christopher
Phyllis Rankin
B: 1923-04-08
D: 2017-06-12
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Rankin, Phyllis
Rodney Restoff
B: 1969-12-28
D: 2017-06-10
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Restoff, Rodney
Eileen Kidd
B: 1951-01-26
D: 2017-06-09
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Kidd, Eileen
Jennifer Briesacher
B: 1983-03-13
D: 2017-06-09
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Briesacher, Jennifer
Susan Blacharczyk
B: 1964-09-02
D: 2017-06-07
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Blacharczyk, Susan
Betty Wild
B: 1933-07-14
D: 2017-06-05
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Wild, Betty
Adeline Young
B: 1985-05-12
D: 2017-06-05
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Young, Adeline
Wanda Wente
B: 1937-08-27
D: 2017-06-03
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Wente, Wanda
Marlene Cange
B: 1934-07-10
D: 2017-06-02
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Cange, Marlene
James Mueller
B: 1954-04-12
D: 2017-05-30
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Mueller, James
Salvatore Paolucci
B: 1933-08-04
D: 2017-05-27
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Paolucci, Salvatore
John Bean
B: 1942-01-29
D: 2017-05-26
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Bean, John
Raymond Miller
B: 1964-07-11
D: 2017-05-25
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Miller, Raymond
Marcus LeRoy
B: 1931-01-06
D: 2017-05-23
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LeRoy, Marcus
Janet Schoppe
B: 1944-06-20
D: 2017-05-21
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Schoppe, Janet
Doris LeRoy
B: 1940-01-27
D: 2017-05-16
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LeRoy, Doris
William Cowgill
B: 1950-11-20
D: 2017-05-16
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Cowgill, William
Ann Kolbeck
B: 1930-07-27
D: 2017-05-15
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Kolbeck, Ann

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LEBANON, IL 62254
Phone: 618-622-4900
Fax: 618-622-4949

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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:

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