Obituaries

Antonio Tenuta
B: 1930-07-03
D: 2018-12-11
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Tenuta, Antonio
Lloyd Gahart
B: 1926-06-26
D: 2018-12-09
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Gahart, Lloyd
Doris Frederick
B: 1927-03-16
D: 2018-12-08
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Frederick, Doris
Frank DeLuca
B: 1936-03-08
D: 2018-12-06
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DeLuca, Frank
Comal Subramanian
B: 1922-07-01
D: 2018-12-04
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Subramanian, Comal
Peter Ortiz
B: 1930-10-22
D: 2018-12-02
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Ortiz, Peter
George Otto
B: 1940-05-13
D: 2018-11-29
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Otto, George
MaryJane Tyson
B: 1933-01-31
D: 2018-11-28
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Tyson, MaryJane
Jerome Clarke
B: 1943-04-26
D: 2018-11-27
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Clarke, Jerome
Arthur West
B: 1959-01-15
D: 2018-11-27
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West, Arthur
Edward Hoff
B: 1930-10-23
D: 2018-11-27
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Hoff, Edward
Robert Ramsdell
B: 1923-02-08
D: 2018-11-25
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Ramsdell, Robert
Richard Peltier
B: 1934-06-24
D: 2018-11-21
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Peltier, Richard
Nancy Domenk
B: 1937-09-19
D: 2018-11-20
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Domenk, Nancy
Jacqueline Henderson
B: 1947-12-25
D: 2018-11-19
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Henderson, Jacqueline
Joan Ekkela
B: 1939-09-27
D: 2018-11-17
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Ekkela, Joan
Ruth Orth
B: 1921-04-02
D: 2018-11-17
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Orth, Ruth
Lynn Van Hazinga
B: 1956-12-03
D: 2018-11-17
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Van Hazinga, Lynn
Teodoro Bilotto
B: 1970-08-16
D: 2018-11-12
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Bilotto, Teodoro
Ronald Kosman
B: 1956-08-17
D: 2018-11-12
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Kosman, Ronald
Jacob Drissel
B: 1952-01-13
D: 2018-11-11
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Drissel, Jacob

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5111-60th Street
Kenosha, WI 53144
Phone: (262) 654-3533
Fax: (262) 654-3539

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I. Biographical Information
 
Full Name:
Date of Death:
Address1:
Address2:
City Name:
State:
Zip Code:
Telephone Number: (xxx-xxx-xxxx)
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Date of Birth: (month/day/year)
City of Birth:
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Highest Education Level:
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Social Security Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:
Father's Name:
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Mother's Name:
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Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded In Death
Occupation:
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Company Name:
Church Membership:
Lodge or Union Name:

II. Military Record

Veteran:
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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:
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III. Service Preferences

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Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
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Outer Container Preference: (for ground burial)
Cemetery Name:
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The cemetery property is in the name of:

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