Obituaries

Kirk Leenig
B: 1949-07-26
D: 2018-06-20
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Leenig , Kirk
Patricia Bardzell
B: 1940-07-19
D: 2018-06-17
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Bardzell, Patricia
Anna M. Ferraro
B: 1929-11-09
D: 2018-06-07
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Ferraro, Anna M.
Julia Smith
B: 1926-04-21
D: 2018-05-31
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Smith, Julia
Michael Laurenzo
B: 1962-10-21
D: 2018-05-31
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Laurenzo, Michael
Geraldine Garner
B: 1922-05-01
D: 2018-05-29
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Garner, Geraldine
Kathryn Walker
B: 1924-06-16
D: 2018-05-28
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Walker, Kathryn
Jozefa Zysk
B: 1935-12-20
D: 2018-05-28
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Zysk, Jozefa
Judy Petrozelli
B: 1963-07-19
D: 2018-05-24
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Petrozelli, Judy
Mary Lou Geadrities
D: 2018-05-21
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Geadrities , Mary Lou
Ronald E. Flynn
B: 1931-11-27
D: 2018-05-20
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Flynn, Ronald E.
Richard Datz
B: 1946-11-03
D: 2018-05-20
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Datz , Richard
Virginia Marie Conlon
B: 1924-05-15
D: 2018-05-04
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Conlon , Virginia Marie
Ling Ju Wang
B: 1968-07-22
D: 2018-05-04
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Wang , Ling Ju
Leslie Mary Campo
B: 1956-10-27
D: 2018-05-02
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Campo, Leslie Mary
Yukiko Le Marr
B: 1930-12-16
D: 2018-04-25
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Le Marr, Yukiko
Maryann Dimm
D: 2018-04-25
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Dimm, Maryann
Teresa Bronico
B: 1944-07-10
D: 2018-04-25
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Bronico, Teresa
Salvatore Bentivegna
B: 1931-03-12
D: 2018-04-21
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Bentivegna, Salvatore
Jon Simonson
B: 1964-09-12
D: 2018-04-18
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Simonson, Jon
Steven J Nienstedt
B: 1952-11-27
D: 2018-04-17
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Nienstedt, Steven J

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Rutherford, NJ 07070
Phone: (201) 939-1050
Fax: (201) 939-2070

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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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