Obituaries

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
Charles Pejakovich
B: 1934-03-18
D: 2017-05-15
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Pejakovich, Charles
Randall Winter
B: 1957-02-17
D: 2017-05-15
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Winter, Randall
Virginia Schemmer
B: 1928-08-19
D: 2017-05-14
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Schemmer, Virginia
Roger Frederickson
B: 1928-12-07
D: 2017-05-04
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Frederickson, Roger
Dennis Feist
B: 1941-05-08
D: 2017-05-03
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Feist, Dennis
Michael Stilwell
B: 1949-06-09
D: 2017-05-02
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Stilwell, Michael
Patricia Kovarik
B: 1929-06-05
D: 2017-05-01
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Kovarik, Patricia
Jack Davis
B: 1939-02-28
D: 2017-04-23
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Davis, Jack
Robert Hollenkamp
B: 1948-06-17
D: 2017-04-22
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Hollenkamp, Robert
Robert Heatherly
B: 1957-02-20
D: 2017-04-13
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Heatherly, Robert
Brenda Moore
B: 1944-08-29
D: 2017-04-11
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Moore, Brenda
Dennis Jacober
B: 1944-12-13
D: 2017-04-10
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Jacober, Dennis
Richard McClelland
B: 1944-06-24
D: 2017-03-29
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McClelland, Richard
Carolyn James
B: 1938-01-10
D: 2017-03-23
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James, Carolyn
Adeline Cooper
B: 1939-01-07
D: 2017-03-21
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Cooper, Adeline

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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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