Charles Thomas
B: 1938-08-24
D: 2016-10-18
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Thomas, Charles
Emil King
B: 1945-04-18
D: 2016-10-11
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King, Emil
Anita Frame
B: 1940-07-15
D: 2016-10-09
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Frame, Anita
Donald Trump
B: 1924-12-29
D: 2016-10-08
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Trump, Donald
Susan Cook-Sheetz
B: 1939-10-24
D: 2016-10-05
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Cook-Sheetz, Susan
Arthur Geisleman
B: 1929-02-17
D: 2016-09-30
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Geisleman, Arthur
Gladys Braun
B: 1926-03-28
D: 2016-09-30
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Braun, Gladys
Patsy Coffelt
B: 1929-05-27
D: 2016-09-30
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Coffelt, Patsy
Jack Buuck
B: 1957-01-22
D: 2016-09-26
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Buuck, Jack
Daniel Freiburger
B: 1963-04-17
D: 2016-09-26
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Freiburger, Daniel
Donald Hartsock
B: 1937-01-10
D: 2016-09-21
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Hartsock, Donald
Anna Hooley
B: 1925-09-22
D: 2016-09-10
View Details
Hooley, Anna
Donna Maples
B: 1943-04-10
D: 2016-09-09
View Details
Maples, Donna
Annabelle Hoy
B: 1924-05-09
D: 2016-09-07
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Hoy, Annabelle
Stephanie Kidd
B: 1942-03-29
D: 2016-08-29
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Kidd, Stephanie
Rosemary Carley
B: 1929-09-06
D: 2016-08-27
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Carley, Rosemary
Homer Rollins
B: 1919-12-25
D: 2016-08-26
View Details
Rollins, Homer
Darlean Dupre
B: 1947-05-31
D: 2016-08-20
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Dupre, Darlean
Loril Hartman
B: 1930-09-12
D: 2016-08-20
View Details
Hartman, Loril
Paul Bridgett
B: 1930-02-13
D: 2016-08-18
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Bridgett, Paul
Mary Vangeli
B: 1932-06-06
D: 2016-08-13
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Vangeli, Mary


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8408 Covington Road
Fort Wayne, IN 46804
Phone: (260) 432-2508
Fax: (260) 436-5150

Immediate Need

First, let us say that we are so sorry for your loss. If at this time you would prefer to expedite your time with our staff in the funeral home you may submit the basic yet required information beforehand. Simply use the Immediate Need form to submit these details to our staff.

I. Biographical Information
Full Name:
Date of Death:
City Name:
Zip Code:
Telephone Number:
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
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:

Miscellaneous Notes and Instructions:

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Please place my information on file


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