Obituaries

Paul Walker
B: 1955-09-02
D: 2017-09-22
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Walker, Paul
Doris Huggins
B: 1937-06-05
D: 2017-09-21
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Huggins, Doris
Billy Radcliff
D: 2017-09-20
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Radcliff, Billy
Sylvia Madrid
B: 1939-11-05
D: 2017-09-19
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Madrid, Sylvia
Jimmy Goodnight
D: 2017-09-19
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Goodnight, Jimmy
James Taylor
B: 1947-03-10
D: 2017-09-16
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Taylor, James
Billie Bradley
B: 1930-10-30
D: 2017-09-13
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Bradley, Billie
Mike Swofford
B: 1961-01-13
D: 2017-09-03
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Swofford, Mike
Kevin Murray
B: 1956-04-29
D: 2017-09-03
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Murray, Kevin
Larry Crafton
B: 1943-06-01
D: 2017-09-02
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Crafton, Larry
Joan Engelhardt
B: 1932-10-29
D: 2017-09-01
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Engelhardt, Joan
Harold Christian
B: 1944-07-03
D: 2017-08-28
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Christian, Harold
Louis Smith
B: 1947-12-22
D: 2017-08-26
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Smith, Louis
Danny Collins
B: 1953-01-20
D: 2017-08-24
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Collins, Danny
Karen Bates
B: 1947-08-10
D: 2017-08-21
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Bates, Karen
Bonnie Hamner
B: 1937-11-25
D: 2017-08-15
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Hamner, Bonnie
Virginia Romines
B: 1934-04-11
D: 2017-08-12
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Romines, Virginia
Gillette Campbell
B: 1927-07-20
D: 2017-08-01
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Campbell, Gillette
Donald Hutchcroft
B: 1947-05-26
D: 2017-07-29
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Hutchcroft, Donald
Bessie Tillery
B: 1929-05-04
D: 2017-07-27
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Tillery, Bessie
James Ayers
B: 1936-11-02
D: 2017-07-27
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Ayers, James

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P.O. Box 1399
CLINTON, AR 72031
Phone: 501-745-6791
Fax: 501-745-6792

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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:
         

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