Obituaries

George Lynch
D: 2017-12-09
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Lynch, George
Ronald Wiggins
B: 1936-12-30
D: 2017-12-05
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Wiggins, Ronald
Audrey Ruther
B: 1933-06-05
D: 2017-12-04
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Ruther, Audrey
Shirley Push
B: 1930-12-24
D: 2017-12-03
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Push, Shirley
Donald Heldt
B: 1942-05-12
D: 2017-12-02
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Heldt, Donald
Harold Gulbranson
B: 1933-04-23
D: 2017-12-02
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Gulbranson, Harold
Ruth Vaught
B: 1919-09-27
D: 2017-12-02
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Vaught, Ruth
Joyce Tator
B: 1948-05-31
D: 2017-11-28
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Tator, Joyce
Marsha Huff
B: 1961-02-24
D: 2017-11-22
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Huff, Marsha
Carol Bahn
B: 1949-05-11
D: 2017-11-20
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Bahn, Carol
James Barker
B: 1934-03-28
D: 2017-11-19
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Barker, James
Renee Fox
B: 1969-12-11
D: 2017-11-15
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Fox, Renee
Patricia Westergard
B: 1946-08-21
D: 2017-11-13
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Westergard, Patricia
Grace Guthrie
B: 1923-07-15
D: 2017-11-13
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Guthrie, Grace
Jean Carpenter
B: 1948-08-26
D: 2017-11-04
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Carpenter, Jean
Marilyn Roe
B: 1933-08-11
D: 2017-11-02
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Roe, Marilyn
Joseph Brokaw
B: 1989-11-29
D: 2017-10-30
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Brokaw, Joseph
Martin Pojar
B: 1937-05-02
D: 2017-10-29
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Pojar, Martin
Dr. Monte Scott
B: 1932-08-23
D: 2017-10-26
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Scott, Dr. Monte
Gary Markmann
B: 1955-09-06
D: 2017-10-26
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Markmann, Gary
Terry Freeman
B: 1947-11-03
D: 2017-10-25
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Freeman, Terry

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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:

Please select one of the options below:

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Please contact me to schedule an appointment

Please place my information on file


 

 

 

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