Annie MacGillivray
D: 2020-04-07
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MacGillivray, Annie
Michele Alexander
D: 2020-04-07
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Alexander, Michele
James Keesee
D: 2020-04-06
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Keesee, James
Joubert Sance
D: 2020-04-06
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Sance, Joubert
Louis Emmanuel
D: 2020-04-04
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Emmanuel, Louis
Richard Dacidson
D: 2020-04-03
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Dacidson, Richard
Gertrude Martince
D: 2020-04-02
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Martince, Gertrude
Ermilis Kucayo
D: 2020-04-02
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Kucayo, Ermilis
Fannie Calabro
D: 2020-04-01
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Calabro, Fannie
Louise DeVito
D: 2020-04-01
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DeVito, Louise
Justina Contreras
D: 2020-04-01
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Contreras, Justina
Serge Emmanuel
D: 2020-03-31
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Emmanuel, Serge
Kenneth Brewley
D: 2020-03-31
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Brewley, Kenneth
Mellicie Paisible
D: 2020-03-31
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Paisible, Mellicie
Harriet Augustine
D: 2020-03-31
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Augustine, Harriet
Keith Simpson
D: 2020-03-31
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Simpson, Keith
James Owen Hunte
D: 2020-03-30
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Hunte, James Owen
Joseph Shores
D: 2020-03-29
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Shores, Joseph
Celitane Gere
D: 2020-03-28
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Gere, Celitane
Brian D. Shields
D: 2020-03-28
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Shields, Brian D.
Zerita Constantine
D: 2020-03-28
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Constantine, Zerita


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I. Biographical Information
Full Name:
Date of Death:
City Name:
Zip Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
State of Birth:
Highest Education Level:
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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
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:

II. Military Record

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:
Person in Charge of Arrangements:
Officiating Clergy:
Flower Preference:
Music Selection:
Casket Preference:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

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