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Biogrphical Record Form
 
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Momorial Video Tribute


 

awfsBiographical Record Formawfs

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[Click here to download form]   
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BIOGRAPHICAL INFORMATION REQUIRED
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First Name
Middle Name
Last Name
Maiden Name
Social Security Number
US War Veteran
Yes No

Residence Address
Years Residing
City
State
Zip

Mailing Address
City
State
Zip

Town of Former Residence
Years Residing
Date of Birth
Birthplace

FAMILY INFORMATION
Father's First Name
Father's Middle Name
Father's Last Name
Father Birthplace
Mother's First Name
Mother's Middle Name
Mother's Last Name
Mother's Maiden Name
Mother's Birthplace
 

Ethnic Origin
Hispanic
Yes No
Race

Marital Status
married widowed never married divorced
Spouse's First Name Spouse's Middle Name Spouse's Last Name
Spouse's Maiden Name    

USUAL OCCUPATION
Give kind of work done during most of working life. DO NOT use retired
Occupation
Employer
Years Employed
Other Places of Employment you may want included in newspaper notice

SURVIVORS
NAME RELATIONSHIP CITY & STATE OF RESIDENCE
plus Click to type more Survivors
PREDECEASED FAMILY MEMBERS - Name only required

Education

Clubs/Organizations/Hobbies
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VETERAN'S SERVICE RECORD
Veteran's service information can be obtained from the DD 214 (Discharge Papers). A DD 214 is a REQUIRED document for ANY military honors or burial.
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Date & Place entered Service
Date & Place Discharged
Branch of Service
Rank at time of Discharge
Service Serial Number or Claim Number
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CEMETERY INFORMATION
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Cemetery Name
Lot
Section Number
Date of Last Interment in Lot
   
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CHURCH & CLERGY NAME INFORMATION
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Church
Clergy Name
 

Memorial Contributions Requested Yes No
Name of Charity/Charities or Organization/s
Address
City
State
Zip

PICTURE

A picture can be used in the newspaper with the obituary or it may be used for the hairdresser to reference
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Next of Kin Name *
(if different from Sender)
Next of Kin contact #*
Next of Kin email
Next of Kin Address*
City*
State*
Zip*
   

Sender's Name*
Sender's e-mail*
Sender's contact #*
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Anderson Winfield Funeral Home
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