Obituary Information Form

Personal Information

Last Name*:

First Name*:

Middle Name:

Age*:

Professional Title:

Military Rank:

Date of Death*:

Place of Death*:

Cause of Death:

Date of Birth*:

Birthplace*:

Parent Names*:

Highschool/College:

Graduation Year:

Spouse(s):

Marriage Date(s):

Occupation(s):

Position(s):

Awards:

Accomplishments:

Membership(s):

Date(s):

Volunteer Position(s):

Date(s):

Religious Affiliation:

Church:

Hobbies/Interests:

Survivor(s):

Predeceased by:

Funeral Date & Time*:

Location of Service*:

Cremation/Internment:

Officiant:

Visitation/Service*:

Special Thanks/Requests:

Address for Flowers/Donations

Address:

City:

Country:

State/Province:

Zip/Postal code:

Contact Information*:

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Contact Information

142 West Washington Avenue,
Washington, NJ 07882
Phone: (908) 689-0046
Email: knolldevoefh@gmail.com

Christopher Knoll, Manager - Director of Funeral and Cremation Services NJ License No. 4460

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