Obituaries

James Davis
B: 1921-08-11
D: 2018-10-13
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Davis, James
Ona Phillips
B: 1927-08-08
D: 2018-10-07
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Phillips, Ona
Newman Stutts
B: 1942-09-29
D: 2018-10-07
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Stutts, Newman
Lloyd Dollar
B: 1937-06-18
D: 2018-10-05
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Dollar, Lloyd
Nowlin "Corky" Cox
B: 1936-07-25
D: 2018-10-02
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Cox, Nowlin "Corky"
Opal Rakes
B: 1930-11-28
D: 2018-10-01
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Rakes, Opal
Doris Shafer
B: 1924-11-30
D: 2018-10-01
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Shafer, Doris
Nelson Reed
B: 1941-10-31
D: 2018-09-25
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Reed, Nelson
Zelda Williams
B: 1940-02-08
D: 2018-09-22
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Williams, Zelda
Jimmy Leverich
B: 1935-02-15
D: 2018-09-14
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Leverich, Jimmy
David Dennis
B: 1968-12-06
D: 2018-09-01
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Dennis, David
Esperanza Cano-Borrego
B: 1998-01-19
D: 2018-08-31
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Cano-Borrego, Esperanza
James Dean
B: 1929-08-30
D: 2018-08-31
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Dean, James
LaVada Poindexter Beard
B: 1930-11-16
D: 2018-08-22
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Poindexter Beard, LaVada
Gwindolene Latimer
B: 1926-11-10
D: 2018-08-12
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Latimer, Gwindolene
Ghronda Tarpley-Adam
B: 1950-09-28
D: 2018-08-10
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Tarpley-Adam, Ghronda
Jimmie Middleton
B: 1934-01-22
D: 2018-07-31
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Middleton, Jimmie
Troy Deen
B: 1957-02-05
D: 2018-07-29
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Deen, Troy
Robert Rifenburgh
B: 1934-07-18
D: 2018-07-24
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Rifenburgh, Robert
Betty Roland
B: 1954-09-02
D: 2018-06-27
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Roland, Betty
Oretha Sipe Caffey
B: 1932-01-29
D: 2018-06-27
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Sipe Caffey, Oretha

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201 Edwards St
Merkel, TX 79536
Phone: (325) 928-4711
Fax: (325) 928-3078

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Use this form to provide the information we need when you are arranging a funeral with us for someone that has just passed away. We are also available to take this information over the phone or when you meet with us to plan the arrangements. Feel free to call us with any questions at (325) 928-4711.


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:

Please select one of the options below:

Please send me information

Please contact me to schedule an appointment

Please place my information on file