Obituaries

Ruth Sherrod
B: 1932-01-14
D: 2017-11-13
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Sherrod, Ruth
George Hiner
B: 1942-04-12
D: 2017-11-10
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Hiner, George
Elmer Hinton
B: 1927-05-09
D: 2017-11-06
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Hinton, Elmer
Lucy Anders
B: 1930-10-07
D: 2017-11-05
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Anders, Lucy
Jimmy Elliott
B: 1942-10-19
D: 2017-10-30
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Elliott, Jimmy
Leroy Lucero
B: 1962-12-26
D: 2017-10-28
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Lucero, Leroy
Adrian Stroup
B: 1939-03-08
D: 2017-10-26
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Stroup, Adrian
Ethel Mullins
B: 1916-02-20
D: 2017-10-19
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Mullins, Ethel
Patricia Mathis
B: 1948-10-19
D: 2017-10-16
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Mathis, Patricia
Eduvigen Pena
B: 1927-01-21
D: 2017-10-16
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Pena, Eduvigen
Jimmy Adams
B: 1943-03-12
D: 2017-10-16
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Adams, Jimmy
Dwayne Glover
B: 1934-04-18
D: 2017-10-15
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Glover, Dwayne
Dulces Valdez
B: 1950-04-25
D: 2017-10-13
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Valdez, Dulces
Frank Cheney
B: 1923-01-29
D: 2017-10-13
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Cheney, Frank
William Smith
B: 1932-10-12
D: 2017-10-08
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Smith, William
J. Latta
B: 1922-10-30
D: 2017-10-07
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Latta, J.
Noel Owen
B: 1929-12-12
D: 2017-10-07
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Owen, Noel
Lois Folkner
B: 1919-01-17
D: 2017-10-05
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Folkner, Lois
Melvin Littlejohn
B: 1926-05-28
D: 2017-10-05
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Littlejohn, Melvin
Daniel Machen
B: 1990-08-31
D: 2017-09-28
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Machen, Daniel
Kaceylyn Olivas
B: 2017-09-19
D: 2017-09-23
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Olivas, Kaceylyn

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500 E Third St.
P O Box 116
Portales, NM 88130
Phone: (575) 356-4455
Fax: (575) 356-2646
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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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