Obituaries

Mary Groff
B: 1934-04-15
D: 2017-05-26
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Groff, Mary
Robert Gerhard
B: 1947-07-20
D: 2017-05-25
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Gerhard, Robert
Mary Hoover
B: 1929-05-10
D: 2017-05-24
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Hoover, Mary
Dorothy Borst
B: 1931-07-30
D: 2017-05-22
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Borst, Dorothy
Craig McNichol
B: 1969-11-15
D: 2017-05-21
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McNichol, Craig
Thomas Ishler
B: 1932-06-22
D: 2017-05-20
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Ishler, Thomas
William Kurtz
B: 1928-01-03
D: 2017-05-20
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Kurtz, William
John Burkholder
B: 1933-01-18
D: 2017-05-18
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Burkholder, John
Anna Shirk
B: 1931-06-20
D: 2017-05-18
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Shirk, Anna
Harold Witmer
B: 1931-01-16
D: 2017-05-16
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Witmer, Harold
Phyllis Keller
B: 1935-12-19
D: 2017-05-14
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Keller, Phyllis
Paul Weber
B: 1919-06-22
D: 2017-05-14
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Weber, Paul
Harley Gordner
B: 1936-10-28
D: 2017-05-13
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Gordner, Harley
Robert Strickler
B: 1935-10-08
D: 2017-05-13
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Strickler, Robert
Beatrice Crowther
B: 1923-03-16
D: 2017-05-11
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Crowther, Beatrice
Harold Martin
B: 1916-10-30
D: 2017-05-09
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Martin, Harold
Robert Hurst
B: 1936-09-07
D: 2017-05-08
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Hurst, Robert
Dorothy Usner
B: 1925-11-04
D: 2017-05-05
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Usner, Dorothy
Clifford Fisher
B: 1949-05-01
D: 2017-05-04
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Fisher, Clifford
Minerva Horst
B: 1932-04-19
D: 2017-04-29
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Horst, Minerva
Gary Haas
B: 1951-03-30
D: 2017-04-27
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Haas, Gary

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145 West Main St.
Supervisor: R. Fred Groff III
New Holland, PA 17557
Phone: 717-354-0444
Fax:

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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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