Obituaries

David King
B: 1945-08-02
D: 2017-10-18
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King, David
Susan Rioux
D: 2017-10-18
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Rioux, Susan
Charles Emond
B: 1944-08-26
D: 2017-10-17
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Emond, Charles
Pornphan Wasnanankun
B: 1947-08-31
D: 2017-10-11
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Wasnanankun, Pornphan
Richard Watts
B: 1960-08-22
D: 2017-10-10
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Watts, Richard
Robert Cote
B: 1942-04-06
D: 2017-10-10
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Cote, Robert
William Marshall
B: 1921-03-02
D: 2017-10-09
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Marshall, William
Jean Roth
B: 1946-06-17
D: 2017-10-09
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Roth, Jean
Doris Corneau
B: 1923-12-14
D: 2017-10-05
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Corneau, Doris
Kenneth Mermer
B: 1947-11-17
D: 2017-10-04
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Mermer, Kenneth
Rosa Fowler
B: 1958-11-02
D: 2017-09-28
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Fowler, Rosa
Adrian Piccolo
B: 1942-01-07
D: 2017-09-24
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Piccolo, Adrian
Eric Brophy
B: 1984-03-15
D: 2017-09-22
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Brophy, Eric
Beatrice Lavoie
B: 1920-09-24
D: 2017-09-22
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Lavoie, Beatrice
Angie Roig
B: 1988-09-16
D: 2017-09-22
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Roig, Angie
Brenda Sergeant
B: 1945-06-29
D: 2017-09-22
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Sergeant, Brenda
Dorothea Price
B: 1933-05-25
D: 2017-09-21
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Price, Dorothea
James Smith
B: 1931-11-26
D: 2017-09-17
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Smith, James
Joseph Rock
B: 1921-09-11
D: 2017-09-17
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Rock, Joseph
Daniel Wilkerson
B: 1922-10-24
D: 2017-09-16
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Wilkerson, Daniel
Robert Bartlett
B: 1937-07-19
D: 2017-09-14
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Bartlett, Robert

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Phone: (603) 883-3401
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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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