Obituaries

Betty Overly
B: 1925-02-26
D: 2018-12-15
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Overly, Betty
Mary Brill
B: 1924-07-03
D: 2018-12-08
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Brill, Mary
James Stauffer
B: 1939-09-13
D: 2018-11-18
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Stauffer, James
Jane Herr
B: 1944-12-23
D: 2018-10-08
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Herr, Jane
Anne Johnson
B: 1919-01-05
D: 2018-10-04
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Johnson, Anne
Steven Wagner
B: 1960-08-19
D: 2018-08-18
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Wagner, Steven
Jimmie Collins
B: 1936-08-25
D: 2018-08-16
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Collins, Jimmie
Robert Monger
B: 1939-10-10
D: 2018-07-29
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Monger, Robert
Arlene Torres
B: 1942-07-24
D: 2018-07-18
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Torres, Arlene
Connie Campbell
B: 1958-03-01
D: 2018-07-17
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Campbell, Connie
Jay Stover
B: 1933-03-08
D: 2018-07-15
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Stover, Jay
Ruth Yost
B: 1934-11-03
D: 2018-07-06
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Yost, Ruth
James Harshaw
B: 1933-07-23
D: 2018-07-01
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Harshaw, James
Laura Putt
B: 1957-12-09
D: 2018-06-28
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Putt, Laura
Michael Grimm
B: 1940-05-11
D: 2018-05-19
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Grimm, Michael
Lilliana Smoker
B: 2018-05-06
D: 2018-05-09
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Smoker, Lilliana
Marlene Dyer
B: 1942-01-12
D: 2018-04-14
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Dyer, Marlene
Hector Ramos
B: 1963-11-20
D: 2018-04-05
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Ramos, Hector
Gerald Hershey
B: 1926-09-25
D: 2018-03-30
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Hershey, Gerald
Samuel Allgyer
B: 1935-08-20
D: 2018-03-24
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Allgyer, Samuel
Roy Dunlap
B: 1959-10-24
D: 2018-03-16
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Dunlap, Roy

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315 East Main St.
Supervisor: Sven E. Miller
New Holland, PA 17557
Phone: (717) 354-2227
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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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Please place my information on file


 

 

 

 

 

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