Obituaries

Roshni Hardowar
B: 1977-03-07
D: 2019-12-10
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Hardowar, Roshni
Otis Thomas
B: 1935-03-21
D: 2019-12-04
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Thomas, Otis
Ramon Clemente
B: 1963-10-18
D: 2019-11-30
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Clemente, Ramon
Gurmit Kaur
B: 1949-01-30
D: 2019-11-26
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Kaur, Gurmit
Crystal Harrypersad
B: 1983-06-02
D: 2019-11-24
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Harrypersad, Crystal
LeBarnes McClure
B: 1964-08-23
D: 2019-11-23
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McClure, LeBarnes
Dhanraj No Last Name
B: 1940-11-30
D: 2019-11-17
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No Last Name, Dhanraj
Olga Leoro
B: 1925-10-11
D: 2019-11-16
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Leoro, Olga
Ramsawak Babudial
B: 1952-12-10
D: 2019-11-11
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Babudial, Ramsawak
Fred Rodriguez
B: 1964-05-20
D: 2019-11-06
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Rodriguez, Fred
Molly Rampersad
B: 1966-07-20
D: 2019-11-04
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Rampersad, Molly
Nat Jefferies,
B: 1941-03-20
D: 2019-11-03
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Jefferies,, Nat
Surojadai Mohabir
B: 1978-09-13
D: 2019-11-01
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Mohabir, Surojadai
Amrik Singh Walia
B: 1942-09-15
D: 2019-10-30
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Walia, Amrik Singh
Shiv Singh
B: 1930-08-15
D: 2019-10-28
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Singh, Shiv
Pushpa Topo
B: 1968-08-20
D: 2019-10-27
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Topo, Pushpa
Penelope Bowens
B: 1957-07-20
D: 2019-10-26
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Bowens, Penelope
Juraman Rampaul
B: 1955-10-31
D: 2019-10-25
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Rampaul, Juraman
Gurjit Kaur
B: 1938-06-20
D: 2019-10-24
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Kaur, Gurjit
Arjinder Singh
B: 1978-01-01
D: 2019-10-24
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Singh, Arjinder
Josiah Docteur
B: 2016-12-21
D: 2019-10-23
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Docteur, Josiah

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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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