Death Notice Name of person providing information: Your email address: Relationship to deceased Daytime phone Full name of deceased Age City, State Date of death (yyyy-mm-dd) Date of birth (yyyy-mm-dd) Parents names Survive YesNo Date and place of marriage Spouse’s maiden name, if applicable Survive YesNo If yes, where? If no, give date of death, if known Other survivors, list by relationship/give town of residence Names of any deceased children of the descendant Biographical information for deceased Service information, including place of burial and officiating clergy Upload an image:
