Gompf Funeral Services

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Name

Phone

Email

Residence

Social Security #

Informant Name & Address

Date of Birth

Age

Place of Birth

Spouse

Marriage (When & Where)

Name of Parents

Names & Residence of Children

# Grandchildren

# Great Grandchildren

Names & Residence of Brothers & Sisters

Brothers Deceased

Sisters Deceased

Education

Occupation

Military Service

Church Affiliation

Organizations

Visitation Hours

Date of Funeral

Time of Funeral

Place of Funeral

Minister

Burial Place

Memorial Contribution