Obituaries

Aldine Gehring
B: 1920-07-18
D: 2017-07-26
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Gehring, Aldine
Donna Van Dell
B: 1923-05-06
D: 2017-07-22
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Van Dell, Donna
Carie Proud
B: 1969-10-14
D: 2017-07-19
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Proud, Carie
Cora Johnson
B: 1944-10-30
D: 2017-07-13
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Johnson, Cora
Florence DeShazer
B: 1921-08-09
D: 2017-07-05
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DeShazer, Florence
Annie Garges
B: 1930-07-16
D: 2017-07-03
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Garges, Annie
Lois Derrick
B: 1923-09-17
D: 2017-07-03
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Derrick, Lois
Dorris Golay
B: 1925-02-26
D: 2017-07-02
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Golay, Dorris
Cleo Williams
B: 1929-12-14
D: 2017-07-02
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Williams, Cleo
Grace Ketcham
B: 1929-06-26
D: 2017-06-19
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Ketcham, Grace
Hector Arroyo
B: 1991-01-21
D: 2017-06-18
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Arroyo, Hector
Theodore Fellows
B: 1928-03-04
D: 2017-06-15
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Fellows, Theodore
Carol Zimmerman
B: 1936-07-26
D: 2017-06-14
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Zimmerman, Carol
Michael Lee
B: 1950-02-02
D: 2017-06-10
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Lee, Michael
Beverly Whalen
B: 1927-04-04
D: 2017-06-05
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Whalen, Beverly
Rodolfo Salas
B: 1984-08-11
D: 2017-06-05
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Salas, Rodolfo
Kathrine Healy
B: 1951-03-14
D: 2017-06-02
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Healy, Kathrine
Virgil Hulse
B: 1933-08-31
D: 2017-05-30
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Hulse, Virgil
Estelle Lynn
B: 1927-02-05
D: 2017-05-21
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Lynn, Estelle
Casey Taylor
B: 1992-04-15
D: 2017-05-17
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Taylor, Casey
Kathleen Byrd
B: 1948-01-22
D: 2017-05-13
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Byrd, Kathleen

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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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