Obituaries

Theresa Autino
B: 1964-11-09
D: 2017-05-26
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Autino, Theresa
Donald Graham
B: 1937-04-25
D: 2017-05-25
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Graham, Donald
An-Yi Lee
B: 1922-03-10
D: 2017-05-22
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Lee, An-Yi
Annette King
B: 1941-12-29
D: 2017-05-21
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King, Annette
Geraldine Paul
B: 1930-12-10
D: 2017-05-17
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Paul, Geraldine
Richard Desmond
B: 1936-03-07
D: 2017-05-15
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Desmond, Richard
Roseann Barous
B: 1941-05-06
D: 2017-05-15
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Barous, Roseann
Michael Luchento
B: 1958-02-13
D: 2017-05-12
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Luchento, Michael
Peter Sirico
B: 1932-03-09
D: 2017-05-10
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Sirico, Peter
Linda Kennedy
B: 1947-05-03
D: 2017-05-10
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Kennedy, Linda
Daniel Richardson
B: 1920-12-02
D: 2017-05-10
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Richardson, Daniel
Sonia Phillips
B: 1934-11-11
D: 2017-05-08
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Phillips, Sonia
Victor Lopez
B: 1939-03-04
D: 2017-05-07
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Lopez, Victor
Julia Fadem
B: 1933-10-02
D: 2017-05-07
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Fadem, Julia
Frank Parisi
B: 1935-10-21
D: 2017-05-04
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Parisi, Frank
Betsy Wheeler
B: 1931-12-23
D: 2017-05-02
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Wheeler, Betsy
Bridget Kehley
D: 2017-05-01
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Kehley, Bridget
Deidra Remini
B: 1963-11-10
D: 2017-04-29
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Remini, Deidra
Geraldine Lanza
B: 1945-10-03
D: 2017-04-28
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Lanza, Geraldine
George Tadros
B: 1951-01-07
D: 2017-04-27
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Tadros, George
Lucille Ragozine
B: 1934-04-22
D: 2017-04-26
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Ragozine, Lucille

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344 Route 9 North
Manalapan, NJ 07726
Phone: (732) 972-8484
Fax: (732) 972-9225

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I. Biographical Information
Full Name:
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 You In Death            
Your 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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