Obituaries

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
Frank Tarpy
B: 1933-05-25
D: 2017-04-30
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Tarpy, Frank
Kenneth Downs
B: 1927-03-13
D: 2017-04-29
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Downs, Kenneth
LaVonne Cusher
B: 1934-11-23
D: 2017-04-24
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Cusher, LaVonne
Maynard Franck
B: 1945-04-22
D: 2017-04-22
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Franck, Maynard
Kari Van De Walker
B: 1958-06-06
D: 2017-04-20
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Van De Walker, Kari
Russell Palmer
B: 1951-02-28
D: 2017-04-19
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Palmer, Russell
Gertrude Mumm
B: 1918-11-14
D: 2017-04-18
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Mumm, Gertrude
Dolores Shannon
B: 1936-04-25
D: 2017-03-31
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Shannon, Dolores
Edward Fitzgerald
B: 1949-02-13
D: 2017-03-29
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Fitzgerald, Edward
Terry Webster
B: 1948-01-30
D: 2017-03-25
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Webster, Terry
LeRoy Olsen
B: 1947-09-03
D: 2017-03-17
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Olsen, LeRoy
Stella Mazur
B: 1925-02-04
D: 2017-03-16
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Mazur, Stella
Nancy Krempges
B: 1954-09-05
D: 2017-02-25
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Krempges, Nancy

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216 3rd Ave. SE.
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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