Obituaries

Dwight Moore
B: 1956-09-09
D: 2019-10-01
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Moore, Dwight
Ivan Click
B: 1941-01-05
D: 2019-09-26
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Click, Ivan
Michael Arclise
B: 1958-06-04
D: 2019-10-15
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Arclise, Michael
Nancy White
B: 1943-11-27
D: 2019-10-16
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White, Nancy
Joe Woods
B: 1953-09-07
D: 2019-10-12
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Woods, Joe
Brenda Everett
B: 1963-09-08
D: 2019-10-16
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Everett, Brenda
Douglas Holt
B: 1946-10-30
D: 2019-09-21
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Holt, Douglas
Rocky Tarr
B: 1970-02-28
D: 2019-10-09
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Tarr, Rocky
Lella Kelly
B: 1940-08-09
D: 2019-10-12
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Kelly, Lella
Katie Clayton
B: 1994-09-01
D: 2019-10-09
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Clayton, Katie
Lucille Wilson
B: 1920-01-28
D: 2019-10-11
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Wilson, Lucille
Donald Christian
B: 1954-05-21
D: 2019-10-11
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Christian, Donald
Betty Russell
B: 1932-09-14
D: 2019-10-10
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Russell, Betty
Mary Miranda
B: 1932-04-02
D: 2019-10-10
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Miranda, Mary
Lou Ann Freas
B: 1934-09-30
D: 2019-10-08
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Freas, Lou Ann
Zane Pareso
B: 2019-10-10
D: 2019-10-10
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Pareso, Zane
Syble Sherrod
B: 1940-08-23
D: 2019-10-12
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Sherrod, Syble
Michael Grant
B: 1957-11-15
D: 2019-10-03
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Grant, Michael
Barbara Anderson
B: 1941-11-15
D: 2019-10-08
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Anderson, Barbara
Deanna Campise
B: 1938-03-30
D: 2019-10-03
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Campise, Deanna
Edgar Robbins
B: 1927-05-07
D: 2019-10-04
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Robbins, Edgar

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Humble, TX 77396
Phone: 281-441-2171
Fax: 281-441-1445

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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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