Obituaries

Matthew Joseph Occhipinti
D: 2018-05-19
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Occhipinti, Matthew Joseph
Maria Torchia
D: 2018-05-15
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Torchia, Maria
Constance "Tina" Donato
D: 2018-05-12
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Donato, Constance "Tina"
Janet Carol DeStefano Caruso
D: 2018-05-12
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Caruso, Janet Carol DeStefano
Ann F. Boyle
D: 2018-05-10
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Boyle, Ann F.
Marie R. Spina
D: 2018-05-06
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Spina, Marie R.
Antoinette Bell Predpall
D: 2018-05-05
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Predpall, Antoinette Bell
John A. Anastasia
D: 2018-04-30
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Anastasia, John A.
Michael Joseph Rescigno
D: 2018-04-30
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Rescigno, Michael Joseph
Thomas Evancho
D: 2018-04-28
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Evancho, Thomas
Anna Carlo
D: 2018-04-28
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Carlo, Anna
Gloria Rose Summonte Micciulla
D: 2018-04-24
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Micciulla, Gloria Rose Summonte
Elmer Robert Potter
D: 2018-04-23
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Potter, Elmer Robert
Maisie Dziuba
D: 2018-04-22
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Dziuba, Maisie
Jake Anthony Monteiro
D: 2018-04-22
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Monteiro, Jake Anthony
Donald W. Johnson
D: 2018-04-17
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Johnson, Donald W.
Joan K. Palaia
D: 2018-04-14
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Palaia, Joan K.
Angel Luis Acevedo
D: 2018-04-13
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Acevedo, Angel Luis
Armindo R. Bagagem
D: 2018-04-11
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Bagagem, Armindo R.
Donna J. Lizotte
D: 2018-04-03
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Lizotte, Donna J.
Rita L. Moser
D: 2018-04-02
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Moser, Rita L.

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191 Franklin Ave.
P.O. Box 567
Long Branch, NJ 07740
Phone: 732-222-2312
Fax: 732-222-0238

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Personal Information

 

    Thank you for taking the time to complete the personal information form. By completing the following information, you will have time to think about what type of service you may desire, and find it easier to provide correct information.

    The information on this form will help the funeral home complete the death certificate and other required documents. In addition, it will assist in the composition of an obituary, help the funeral director better understand your initial wishes, and expedite the arrangement conference at the funeral home.

    Please complete as much of the form as possible and select the Submit Information tab at the bottom of the page. This will send the information to the funeral home.

    Should you have any questions, please contact the funeral home at any time



Information about the person completing this form:

 

Your Name:

Address:

City/Town/Boro

State:

ZipCode:

Telephone:

Email Address:

I am Planning For:

Specify Other:

 

Vital Information about the person you are planning for:

 

First Name:

Middle Name:

Last Name:

Address:

City/Town/Boro:

State:

Zip Code:

Length of Time Living Here:

Coming From:

Sex:

Race - Ethnicty

Specify Other:

Hispanic Origin:

Specify Other:

Marital Status :

Name of Spouse:

Maiden Name of Spouse:

Name of Partner:

Maiden Name of Partner:

Is Spouse Deceased:

If Yes, Year:

Birthplace:

Date of Birth:

Social Security Number:

Father's Name:

Mother's Name:

Mother's Maiden Name at Birth:


Military Record:

 

Branch of Service:

Name of War:

Copy of Discharge:

Do you need us to file for Lost Discharge?

Honors Requested at Funeral:

Burial at Mititary Cemetery:

 

Education and Employment:

 

Highest Level of Education:

Occupation:

Employer:

Years Employed:

Retired:

Year Retired:

 

Memberships etc:

 

Clubs:

Organizations:

Achievements:

Hobbies:

 

Surviving Family Members:
Please List Name, Town, State

 

Parents:

Spouse:

Partner:

Son(s):

Daughter(s)

Brother(s)

Sister(s)

Grandchildren

Great-Grandchildren

 

Funeral Service Details:

Disposition


Disposition:

Cemetery/Mausoleum:

Location: City/State

Deed Available:

Deed Information: Sec-Lot-Plot-Grave

Religious Affiliation

Name of Church:

Location of Church:

Member/Parishioner:

Music Selections:

Special Requests:

Rites / Visitation

Public Visitation:

Visitation Hours:

Specify Other Hours:

Service will be:

Service Type:

Service/Mass At:

Specify Other Location:

Casket Bearers:

Family Bearers (6):

Additional Considerations

Memorial Donations:

Please List Charities:


 

Other items which may be needed or should be considered would be:
dentures, jewelry, clothing, glasses, photographs and personal memorabillia

Concierge Services

The Damiano Funeral Home offers many services that set us apart from other local funeral homes, We are available to assist you in the following areas:

Flowers, Restaurants, Hotel Accommodations, Monuments, Engraving, Processing of insurance claims, veterans benefits
and social security notifications.

Should you have any questions please
contact our funeral home at any time.

 

                                                   

 

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