Obituaries

Myrtle Glass
B: 1936-03-01
D: 2019-01-17
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Glass, Myrtle
Elmer Fraley
B: 1944-01-31
D: 2019-01-14
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Fraley, Elmer
Marvin Penix
B: 1952-09-12
D: 2018-12-28
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Penix, Marvin
Patricia Evans
B: 1939-12-27
D: 2018-12-19
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Evans, Patricia
Mary Young
B: 1962-12-03
D: 2018-12-15
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Young, Mary
Donald Elam
B: 1942-11-09
D: 2018-12-13
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Elam, Donald
Nell Wilburn
B: 1913-08-24
D: 2018-12-06
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Wilburn, Nell
Gladys Ison
B: 1925-09-28
D: 2018-11-30
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Ison, Gladys
Lillian Whitt
B: 1941-06-22
D: 2018-11-24
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Whitt, Lillian
Doris Barr
B: 1949-07-09
D: 2018-11-24
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Barr, Doris
Jack Strother
B: 1912-10-08
D: 2018-11-01
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Strother, Jack
Carla Seagraves
B: 1965-01-16
D: 2018-10-27
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Seagraves, Carla
General Sparks
B: 1942-05-13
D: 2018-10-12
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Sparks, General
Michael Stanaford
B: 1950-06-17
D: 2018-10-08
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Stanaford, Michael
Thelma McDavid
B: 1933-12-22
D: 2018-09-14
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McDavid, Thelma
Ohlen Wilson
B: 1941-01-13
D: 2018-09-14
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Wilson, Ohlen
Deloris Maggard
B: 1939-08-07
D: 2018-09-11
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Maggard, Deloris
Connie Kiser
B: 1965-03-04
D: 2018-09-02
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Kiser, Connie
Lowell Dickerson
B: 1931-09-17
D: 2018-08-27
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Dickerson, Lowell
Phyllis Flaugher
B: 1945-03-22
D: 2018-08-23
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Flaugher, Phyllis
William Hayes
B: 1938-09-06
D: 2018-08-23
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Hayes, William

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203 West Main Street
Grayson, KY 41143
Phone: 606-474-5114
Fax: 606-474-0840

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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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