Obituaries

Maurice Gass
B: 1935-08-08
D: 2017-09-20
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Gass, Maurice
Michael Clapperton
B: 1956-10-23
D: 2017-09-19
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Clapperton, Michael
Stanley Gerber
B: 1926-08-14
D: 2017-09-12
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Gerber, Stanley
Alvin Burt
B: 1949-02-28
D: 2017-09-12
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Burt, Alvin
Vivian Bethell
B: 1915-10-17
D: 2017-09-12
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Bethell, Vivian
Howard Worley
B: 1923-05-27
D: 2017-09-10
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Worley, Howard
Robert Young
B: 1951-04-29
D: 2017-09-09
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Young, Robert
Keith Gwynn
B: 1925-12-02
D: 2017-09-09
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Gwynn, Keith
Donna Lantz
B: 1955-02-21
D: 2017-09-08
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Lantz, Donna
Clifford Sexton
B: 1927-07-20
D: 2017-09-03
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Sexton, Clifford
Eva Russell
B: 1920-03-09
D: 2017-08-29
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Russell, Eva
Kenneth Kidd
B: 1924-04-10
D: 2017-08-25
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Kidd, Kenneth
Frederick Heider
B: 1941-12-24
D: 2017-08-21
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Heider, Frederick
Irvin Phifer
B: 1933-04-12
D: 2017-08-20
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Phifer, Irvin
Humberto Zapata
B: 1960-10-17
D: 2017-08-20
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Zapata, Humberto
George Cooper
B: 1920-03-05
D: 2017-08-15
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Cooper, George
Shirley Thomas
B: 1938-12-10
D: 2017-08-04
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Thomas, Shirley
Myrna Wagner
B: 1946-04-18
D: 2017-07-30
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Wagner, Myrna
Nonalea Watson
B: 1944-03-03
D: 2017-07-30
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Watson, Nonalea
Jesse Gonzalez
B: 1956-01-21
D: 2017-07-29
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Gonzalez, Jesse
Aldine Gehring
B: 1920-07-18
D: 2017-07-26
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Gehring, Aldine

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201 Oak Grove Road N.W.
Salem, OR 97304
Phone: (503) 585-1373
Fax: (503) 585-4443

Immediate Need

First, let us say that we are so sorry for your loss.

To report a death to Restlawn Funeral Home, please notify us first by phone at (503) 585-1373.

After that call, we will take your loved one into our care and will confirm a time/date for the arrangement conference. If you would prefer to expedite your time with our staff during that arrangement process, you may enter your loved one's basic information in this form below.


I. Informant Information

Full Name of Informant:
Relationship to Deceased:
Informant's Phone Number:
Informant's Email Address:

II. Decedent's Biographical Information

Full Name of Decedent:
Date of Death:
Decedent's Address:
City Name:
State:
Zip Code:
Telephone Number:
Date of Birth:
City of Birth:
State of Birth:
Highest Education Level:
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/Residence
Preceded Relatives
Occupation:
Industry:
Employer's Name:
Church Membership:
Club Affiliations:

III. Decedent's Military Record

Veteran:
Branch of Service:
Serial Number:
Date Enlisted:
Date of Discharge:
Rank at Discharge:
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences

Type of Service:
Visitation Hours:
Casket:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Cemetery Name:
Cemetery Location:

Miscellaneous Notes and Instructions:


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