Obituaries

Satnam Singh
B: 1977-01-17
D: 2018-07-16
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Singh, Satnam
Telia Marie Smith
B: 1961-07-23
D: 2018-07-07
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Smith, Telia Marie
Jack Roth
B: 1927-01-14
D: 2018-07-03
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Roth, Jack
Tessa Jones
B: 1960-09-21
D: 2018-07-02
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Jones, Tessa
Chandrkumari Shamlall
B: 1952-06-18
D: 2018-06-30
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Shamlall, Chandrkumari
Radha Jugroo
B: 1970-02-08
D: 2018-06-26
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Jugroo, Radha
Lucille Ware
B: 1931-09-30
D: 2018-06-26
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Ware, Lucille
Nalinie Campbell
B: 1965-08-05
D: 2018-06-20
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Campbell, Nalinie
Fnu Sukhdeo
B: 1951-10-12
D: 2018-06-18
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Sukhdeo, Fnu
Catherine Balgobin
D: 2018-06-16
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Balgobin, Catherine
Sherry Bundrige
B: 1936-03-05
D: 2018-06-15
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Bundrige, Sherry
Joaquin Aponte
B: 1934-08-16
D: 2018-06-14
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Aponte, Joaquin
Surinder Singh
B: 1942-01-03
D: 2018-06-14
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Singh, Surinder
Evelyn Mimms
B: 1923-02-04
D: 2018-06-11
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Mimms, Evelyn
Rohan Kanhai
B: 1965-02-28
D: 2018-06-10
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Kanhai, Rohan
Gurdeep S. Gahra
B: 1989-07-06
D: 2018-06-04
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Gahra, Gurdeep S.
Ivan McDonald
B: 1936-09-10
D: 2018-05-30
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McDonald, Ivan
Kuldeep Singh
B: 1991-08-16
D: 2018-05-28
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Singh, Kuldeep
Dharamdeo Omwathath
B: 1971-03-11
D: 2018-05-26
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Omwathath, Dharamdeo
Cecil Bender
B: 1951-11-11
D: 2018-05-26
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Bender, Cecil
Shobha Heera
B: 1959-06-22
D: 2018-05-25
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Heera, Shobha

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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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