Obituaries

Tommy Moore
B: 1947-05-08
D: 2018-01-15
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Moore, Tommy
Frieda Miller
B: 1936-08-20
D: 2018-01-12
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Miller, Frieda
Dr. Jayni Flores
B: 1951-09-30
D: 2018-01-11
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Flores, Dr. Jayni
Kyle Mueller
B: 1993-09-03
D: 2018-01-11
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Mueller, Kyle
Jim Wood
B: 1950-06-11
D: 2018-01-07
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Wood, Jim
Joe Ennis
B: 1937-09-22
D: 2018-01-04
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Ennis, Joe
Milton Bonds
B: 1937-06-12
D: 2018-01-03
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Bonds, Milton
Wendell Kelley
B: 1933-12-11
D: 2018-01-01
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Kelley, Wendell
Marion Owens
B: 1932-08-24
D: 2017-12-31
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Owens, Marion
Cecile Kelley
B: 1937-01-21
D: 2017-12-29
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Kelley, Cecile
Justin King
B: 2004-05-02
D: 2017-12-25
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King, Justin
Darlene Turner
B: 1936-06-07
D: 2017-12-21
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Turner, Darlene
Rosie Baker
B: 1944-04-20
D: 2017-12-18
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Baker, Rosie
Sue Wolfe
B: 1938-05-13
D: 2017-12-17
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Wolfe, Sue
Jerry Wimberly
B: 1962-12-03
D: 2017-12-12
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Wimberly, Jerry
June Beard
B: 1933-06-30
D: 2017-12-10
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Beard, June
Marjorie McKinney
B: 1932-09-30
D: 2017-12-05
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McKinney, Marjorie
Winston Berry
B: 1955-08-29
D: 2017-12-02
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Berry, Winston
Blanca Valdez
B: 1959-05-10
D: 2017-11-29
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Valdez, Blanca
Cory Jones
B: 1976-01-19
D: 2017-11-25
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Jones, Cory
Deloris Widener
B: 1953-06-06
D: 2017-11-23
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Widener, Deloris

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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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