Obituaries

Jerome Dukart
B: 1932-10-15
D: 2018-12-14
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Dukart, Jerome
Karen Dostal
B: 1957-07-01
D: 2018-12-07
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Dostal, Karen
Sharon Tollberg
B: 1945-09-05
D: 2018-12-06
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Tollberg, Sharon
Bonnie Huntley
B: 1942-10-04
D: 2018-12-06
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Huntley, Bonnie
Steve Plowman
B: 1944-12-30
D: 2018-12-06
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Plowman, Steve
Sebastian Guar
B: 2018-09-12
D: 2018-12-03
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Guar, Sebastian
Lillian Merico
B: 1942-06-21
D: 2018-12-01
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Merico, Lillian
Michael Fuhrmann
B: 1959-08-20
D: 2018-11-29
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Fuhrmann, Michael
Jane Rohe
B: 1937-04-19
D: 2018-11-29
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Rohe, Jane
Pamela Banwell
B: 1965-03-22
D: 2018-11-27
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Banwell, Pamela
James Meyer
B: 1941-03-25
D: 2018-11-19
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Meyer, James
Joyce Moehring
B: 1920-09-26
D: 2018-11-18
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Moehring, Joyce
David Bickford
B: 1930-12-26
D: 2018-11-17
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Bickford, David
Dorothy Koch
B: 1927-03-27
D: 2018-11-16
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Koch, Dorothy
Judy Steffes
B: 1947-07-22
D: 2018-11-15
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Steffes, Judy
Robert Vanecek
B: 1936-10-01
D: 2018-11-15
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Vanecek, Robert
Ruth Jensen
B: 1938-12-19
D: 2018-11-15
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Jensen, Ruth
Allan Larson
B: 1937-10-09
D: 2018-11-15
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Larson, Allan
Charlotte Pauly
B: 1920-06-26
D: 2018-11-14
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Pauly, Charlotte
Dorothy Thompson
B: 1936-07-27
D: 2018-11-12
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Thompson, Dorothy
Barbara Theisen
B: 1925-11-04
D: 2018-11-11
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Theisen, Barbara

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16394 Glory Lane
Eden Prairie, MN 55344
Phone: (952) 949-4970
Fax: (952) 949-5947

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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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