Obituaries

George Darland
B: 1960-08-30
D: 2017-07-18
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Darland, George
Dawn Rouse
B: 1967-03-03
D: 2017-07-17
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Rouse, Dawn
Harry Backer
B: 1961-08-21
D: 2017-07-17
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Backer, Harry
Kenneth Lynch
B: 1951-12-11
D: 2017-07-05
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Lynch, Kenneth
William Zimpher
B: 1942-03-24
D: 2017-06-27
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Zimpher, William
Lester McGlaughlin
B: 1943-12-14
D: 2017-06-27
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McGlaughlin, Lester
Malachi Cashen
B: 1946-11-03
D: 2017-06-26
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Cashen, Malachi
Jerry Barske
B: 1939-04-12
D: 2017-06-23
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Barske, Jerry
Thomas Miller
B: 1946-10-14
D: 2017-06-23
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Miller, Thomas
Norman Rosene
B: 1924-07-07
D: 2017-06-20
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Rosene, Norman
Mary Hansen
B: 1951-08-27
D: 2017-06-13
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Hansen, Mary
Catherine Newton
B: 1945-02-01
D: 2017-06-04
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Newton, Catherine
William Shafer
B: 1958-09-03
D: 2017-05-28
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Shafer, William
Donald Scheetz
B: 1944-06-28
D: 2017-05-27
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Scheetz, Donald
Darleen Hoeg
B: 1925-01-11
D: 2017-05-20
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Hoeg, Darleen
Mary Reidy Knipp
B: 1923-02-15
D: 2017-05-14
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Reidy Knipp, Mary
Marie Doan
B: 1940-02-22
D: 2017-05-14
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Doan, Marie
Donald Schoenfield
B: 1932-07-17
D: 2017-05-09
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Schoenfield, Donald
John Millard
B: 1957-09-13
D: 2017-05-07
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Millard, John
Christina Moffett
B: 1956-02-15
D: 2017-05-02
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Moffett, Christina
Keith Hoskins
B: 1987-11-09
D: 2017-05-02
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Hoskins, Keith

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Independence, IA 50644
Phone: (319) 334-2501
Fax: (319) 334-2502

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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:

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