Obituaries

Roy Montano
B: 1960-08-07
D: 2017-05-20
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Montano, Roy
Nellie Hern
B: 1932-06-14
D: 2017-05-18
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Hern, Nellie
Joyce Fraze
B: 1934-01-18
D: 2017-05-14
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Fraze, Joyce
Jerome Dever
B: 1941-02-01
D: 2017-05-14
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Dever, Jerome
Susie Tivis
B: 1916-01-24
D: 2017-05-14
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Tivis, Susie
Albert Fails
B: 1920-05-07
D: 2017-05-13
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Fails, Albert
Ada Moorhead
B: 1921-02-21
D: 2017-05-10
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Moorhead, Ada
Nancy Williamson
B: 1928-07-19
D: 2017-05-08
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Williamson, Nancy
Donnie Wilson
B: 1952-01-17
D: 2017-05-07
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Wilson, Donnie
Mildred Bownds
B: 1938-02-14
D: 2017-05-06
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Bownds, Mildred
Daisy McKillip
B: 1924-11-23
D: 2017-04-27
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McKillip, Daisy
Levi Edwards
B: 1960-03-26
D: 2017-04-27
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Edwards, Levi
Daniel Weems
B: 1942-01-26
D: 2017-04-26
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Weems, Daniel
Leon Angevine
B: 1946-11-19
D: 2017-04-23
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Angevine, Leon
Marida Wright
B: 1925-08-14
D: 2017-04-23
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Wright, Marida
Charley Hudson
B: 1933-08-01
D: 2017-04-22
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Hudson, Charley
Jerry Montgomery
B: 1964-05-01
D: 2017-04-22
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Montgomery, Jerry
Cristobal Lovato
B: 1942-04-03
D: 2017-04-19
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Lovato, Cristobal
Ninfa Moreno
B: 1937-07-16
D: 2017-04-17
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Moreno, Ninfa
Aeron Griffin
B: 1954-08-14
D: 2017-04-11
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Griffin, Aeron
Mary Apodaca
B: 1929-03-21
D: 2017-04-05
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Apodaca, Mary

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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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