Obituaries

William Combs
B: 1941-04-13
D: 2017-08-16
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Combs, William
Frank Leffert
B: 1930-06-29
D: 2017-08-13
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Leffert, Frank
Fred Miller
B: 1926-09-11
D: 2017-08-11
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Miller, Fred
Wayne Daugherty
B: 1937-09-26
D: 2017-08-11
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Daugherty, Wayne
Linda Jones
B: 1950-08-29
D: 2017-08-09
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Jones, Linda
Wallace Patterson
B: 1959-03-17
D: 2017-08-04
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Patterson, Wallace
Wilhelm May
B: 1963-02-17
D: 2017-08-03
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May, Wilhelm
Harvey Grigg
B: 1953-08-10
D: 2017-07-31
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Grigg, Harvey
James McMahan
B: 1937-12-29
D: 2017-07-28
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McMahan, James
Raymond Svoboda
B: 1933-07-21
D: 2017-07-28
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Svoboda, Raymond
Steven Hill
B: 1953-11-24
D: 2017-07-28
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Hill, Steven
David May
B: 1951-10-27
D: 2017-07-25
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May, David
Erwin Huelskamp
B: 1936-11-19
D: 2017-07-20
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Huelskamp, Erwin
Daryl O'Leary
B: 1953-07-15
D: 2017-07-20
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O'Leary, Daryl
Dorothy Brush
B: 1931-02-22
D: 2017-07-17
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Brush, Dorothy
Karah Moxley
B: 1951-01-25
D: 2017-07-13
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Moxley, Karah
John Jorns
B: 1960-09-15
D: 2017-07-08
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Jorns, John
Shelby Dickson
B: 1984-01-31
D: 2017-07-08
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Dickson, Shelby
Paul McWhorter
B: 1974-06-26
D: 2017-07-01
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McWhorter, Paul
Eunice Vancil
B: 1935-11-07
D: 2017-06-30
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Vancil, Eunice
Ronald Debatin
B: 1944-05-11
D: 2017-06-29
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Debatin, Ronald

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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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