Obituaries

Donald Jackson
B: 1946-07-09
D: 2017-12-10
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Jackson, Donald
Phyllis Seelhoff
B: 1927-05-11
D: 2017-12-09
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Seelhoff, Phyllis
Brooklyn Thill
B: 2011-06-11
D: 2017-12-08
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Thill, Brooklyn
Juanita Peters
B: 1948-03-30
D: 2017-12-06
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Peters, Juanita
Elizabeth Young
B: 1930-02-12
D: 2017-12-04
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Young, Elizabeth
Douglas Richardson
B: 1942-10-21
D: 2017-12-02
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Richardson, Douglas
Edward Grandbois
B: 1944-08-31
D: 2017-11-30
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Grandbois, Edward
John Mijares
B: 1950-04-27
D: 2017-11-30
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Mijares, John
Rufina Pesina
B: 1950-12-27
D: 2017-11-30
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Pesina, Rufina
Dorothy Vaughan
B: 1918-03-30
D: 2017-11-29
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Vaughan, Dorothy
Rose Miller
B: 1930-07-22
D: 2017-11-28
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Miller, Rose
Adeline Rupple
B: 1942-03-16
D: 2017-11-28
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Rupple, Adeline
Josephine Chavez
B: 1924-01-03
D: 2017-11-27
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Chavez, Josephine
Garry Kennedy
B: 1938-08-26
D: 2017-11-25
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Kennedy, Garry
Robert Duff
B: 1928-11-05
D: 2017-11-25
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Duff, Robert
Katherine Clift
B: 1965-03-03
D: 2017-11-23
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Clift, Katherine
Stanley Wagner
B: 1961-03-13
D: 2017-11-23
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Wagner, Stanley
Donna Jurgens
B: 1937-11-27
D: 2017-11-22
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Jurgens, Donna
Jewell Dobkins
B: 1920-12-17
D: 2017-11-14
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Dobkins, Jewell
Maria De Valdivia
B: 1928-07-28
D: 2017-11-14
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De Valdivia, Maria
Diana Mrogenski
B: 1950-01-10
D: 2017-11-14
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Mrogenski, Diana

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Greeley, CO 80634
Phone: 970-353-1212
Fax: 970-353-4881

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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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