Obituaries

Sharita Smith
B: 1984-01-16
D: 2017-12-11
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Smith, Sharita
Surinder Kaur
B: 1940-06-10
D: 2017-12-09
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Kaur, Surinder
Mitra Toy Ramsook
B: 1951-06-22
D: 2017-12-08
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Ramsook, Mitra Toy
Albertha Nunez
B: 1923-03-27
D: 2017-12-07
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Nunez, Albertha
Inderjit Kaur
B: 1938-08-10
D: 2017-12-01
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Kaur, Inderjit
Kulbir Singh
B: 1961-12-04
D: 2017-11-25
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Singh, Kulbir
James Powell
B: 1965-11-10
D: 2017-11-25
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Powell, James
Audrey Spooner
B: 1923-05-31
D: 2017-11-24
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Spooner, Audrey
Rose Pollock
B: 1914-05-02
D: 2017-11-20
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Pollock, Rose
James Lamb
B: 1937-08-29
D: 2017-11-20
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Lamb, James
Jagjeet Singh
B: 1990-02-13
D: 2017-11-18
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Singh, Jagjeet
Fnu Lakhpatisharma
B: 1939-12-22
D: 2017-11-16
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Lakhpatisharma, Fnu
Laj Kaur
B: 1946-12-04
D: 2017-11-16
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Kaur, Laj
Maureen Gittens
B: 1950-12-17
D: 2017-11-10
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Gittens, Maureen
Kenneth Massop
B: 1932-05-10
D: 2017-11-03
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Massop, Kenneth
Olive Graham
B: 1917-07-01
D: 2017-10-31
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Graham, Olive
Jaspinderjit Singh
B: 1991-09-26
D: 2017-10-24
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Singh, Jaspinderjit
Calvin Twells
B: 1946-08-23
D: 2017-10-19
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Twells, Calvin
Helen Ava Seeraj-Seepaul
B: 1971-02-20
D: 2017-10-19
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Seeraj-Seepaul, Helen Ava
Vashkarnan Jairam
B: 1950-06-02
D: 2017-10-18
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Jairam, Vashkarnan
Joell Singh
B: 1968-10-24
D: 2017-10-14
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Singh, Joell

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Elcock Funeral Home, Inc. ... Your Faith, Our Home ®
130-02 Liberty Ave.
Queens, NY 11419
Phone: (718) 845-7408
Fax: (718) 845-7477

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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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