Obituaries

Shirley Howell
B: 1927-06-24
D: 2017-04-25
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Howell, Shirley
Amy Cromer
B: 1970-11-25
D: 2017-04-22
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Cromer, Amy
Allison Hope
B: 1990-03-07
D: 2017-04-20
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Hope, Allison
Jacob Rosencrantz
B: 1923-01-21
D: 2017-04-17
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Rosencrantz, Jacob
Steven Nichols
B: 1970-09-26
D: 2017-04-13
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Nichols, Steven
Bianca Ballweg
B: 1937-03-23
D: 2017-04-13
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Ballweg, Bianca
Clifford Forrester
B: 1940-04-30
D: 2017-04-12
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Forrester, Clifford
DeAnna Hansen
B: 1964-06-10
D: 2017-04-07
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Hansen, DeAnna
Beverly Zimmerly
B: 1949-09-19
D: 2017-04-02
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Zimmerly, Beverly
John McFarland
B: 1951-08-10
D: 2017-03-29
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McFarland, John
Cheryl Neverve
B: 1961-03-17
D: 2017-03-27
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Neverve, Cheryl
Janey Gustin
B: 1956-04-26
D: 2017-03-26
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Gustin, Janey
Danny Walters
B: 1946-09-20
D: 2017-03-23
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Walters, Danny
Roger Ferrell
B: 1937-03-01
D: 2017-03-23
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Ferrell, Roger
Danne Aldinger
B: 1959-11-16
D: 2017-03-19
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Aldinger, Danne
Rod Paasch
B: 1956-10-25
D: 2017-03-18
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Paasch, Rod
William Howe
B: 1941-04-23
D: 2017-03-16
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Howe, William
Francis Ridder
B: 1950-04-13
D: 2017-03-15
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Ridder, Francis
Marian Kishbaugh
B: 1922-01-16
D: 2017-03-14
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Kishbaugh, Marian
Lucille Noble
B: 1925-07-01
D: 2017-03-03
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Noble, Lucille
Harry Ziegenbein
B: 1937-05-24
D: 2017-03-01
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Ziegenbein, Harry

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21901 W. Maple Rd
P.O. Box 67
Elkhorn, NE 68022
Phone: 402-289-2222
Fax: 402-289-2223

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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:

Miscellaneous Notes and Instructions:

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