Obituaries

Belva Farrey
B: 1941-05-04
D: 2019-04-20
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Farrey, Belva
Earl Lange
B: 1937-10-03
D: 2019-04-14
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Lange, Earl
Sr. Elaine Robbins
B: 1932-07-23
D: 2019-04-05
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Robbins, Sr. Elaine
Frances Hendricks
B: 1921-01-30
D: 2019-03-30
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Hendricks, Frances
Eugene L. "Gene" Kowalski
B: 1923-05-25
D: 2019-03-27
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Kowalski, Eugene L. "Gene"
Helen McQuade
B: 1926-01-09
D: 2019-03-27
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McQuade, Helen
Harold Houtakker
B: 1931-08-02
D: 2019-03-24
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Houtakker, Harold
Julie Pickel
B: 1960-06-25
D: 2019-03-16
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Pickel, Julie
Jack Adams
B: 1959-11-15
D: 2019-03-09
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Adams, Jack
Michael Guild
B: 1971-11-07
D: 2019-03-09
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Guild, Michael
Marvin Kennicker
B: 1938-02-26
D: 2019-03-04
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Kennicker, Marvin
Linda Shepherd
B: 1951-10-06
D: 2019-02-17
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Shepherd, Linda
Priscilla M. "Perce" Edge
B: 1932-09-18
D: 2019-02-13
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Edge, Priscilla M. "Perce"
Patricia A. "Pat" Jerrett
B: 1942-08-21
D: 2019-02-12
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Jerrett, Patricia A. "Pat"
Marie Boldt-Rubbert
B: 1932-03-26
D: 2019-02-11
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Boldt-Rubbert, Marie
Thomas H. "Jack" Robson
B: 1924-12-02
D: 2019-02-09
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Robson, Thomas H. "Jack"
Robert Klein
B: 1931-04-03
D: 2019-02-05
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Klein, Robert
Delbert J. Kaiser
B: 1933-07-16
D: 2019-01-31
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Kaiser, Delbert J.
Jeanette Schleifer
B: 1927-08-07
D: 2019-01-30
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Schleifer, Jeanette
Ronald Vosberg
B: 1937-09-28
D: 2019-01-30
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Vosberg, Ronald
Dorothy Runde
B: 1929-10-11
D: 2019-01-25
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Runde, Dorothy

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123 North Jackson Street
Cuba City, WI 53807
Phone: 608-744-2714
Fax: 608-744-3212

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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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