Obituaries

La Verne Stark
B: 1920-08-25
D: 2017-09-18
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Stark, La Verne
Melody Hodges
B: 1949-04-01
D: 2017-09-12
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Hodges, Melody
Dovie "Marie" Littlejohn
B: 1926-08-01
D: 2017-09-10
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Littlejohn, Dovie "Marie"
William Yates
B: 1995-02-20
D: 2017-09-09
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Yates, William
Herschell Nixon
B: 1956-03-17
D: 2017-09-07
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Nixon, Herschell
Maxine Lucero
B: 1947-10-10
D: 2017-09-01
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Lucero, Maxine
Clarence Hahn
B: 1953-01-18
D: 2017-09-01
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Hahn, Clarence
Gwendolyn Upton
B: 1942-10-13
D: 2017-09-01
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Upton, Gwendolyn
Kalvin Vargas
B: 2016-02-16
D: 2017-08-30
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Vargas, Kalvin
Theressa Wood
B: 1925-01-04
D: 2017-08-29
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Wood, Theressa
Nathaniel Lee
B: 1998-09-12
D: 2017-08-25
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Lee, Nathaniel
Ina Highley
B: 1934-03-13
D: 2017-08-22
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Highley, Ina
Dorla McCoy
B: 1937-11-29
D: 2017-08-20
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McCoy, Dorla
Earl Walker
B: 1927-04-17
D: 2017-08-16
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Walker, Earl
Wanda Gossett
B: 1925-08-24
D: 2017-08-14
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Gossett, Wanda
Carol Self
B: 1949-05-28
D: 2017-08-12
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Self, Carol
Erba Skinner
B: 1931-02-07
D: 2017-07-28
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Skinner, Erba
Michael Marshall
B: 1952-05-05
D: 2017-07-23
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Marshall, Michael
Judith Geiger
B: 1955-09-16
D: 2017-07-21
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Geiger, Judith
Leona Sikes
B: 1925-11-18
D: 2017-07-20
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Sikes, Leona
Presley Morgan
B: 2015-06-06
D: 2017-07-15
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Morgan, Presley

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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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