Obituaries

Mildred Keenum
B: 1944-03-08
D: 2017-08-14
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Keenum, Mildred
Leman Osborn
B: 1944-11-03
D: 2017-08-08
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Osborn, Leman
Andy Hagood
B: 1959-12-15
D: 2017-08-07
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Hagood , Andy
Flora Rooks
B: 1927-09-20
D: 2017-08-02
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Rooks, Flora
Dean Buttram
B: 1934-11-23
D: 2017-07-18
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Buttram, Dean
Patsy Burney
B: 1952-05-13
D: 2017-07-14
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Burney, Patsy
John H. Boston
B: 1931-08-10
D: 2017-07-11
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Boston, John H.
James Hazle
B: 1947-06-11
D: 2017-07-07
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Hazle, James
Audrey McGinnis
B: 1952-08-23
D: 2017-07-07
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McGinnis, Audrey
Teresa Terry
B: 1956-03-04
D: 2017-07-01
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Terry , Teresa
Mildred McDonald
B: 1932-04-10
D: 2017-06-30
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McDonald , Mildred
Celsa Martinez
B: 1913-06-12
D: 2017-06-24
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Martinez, Celsa
Bonnie Marashi
B: 1948-08-14
D: 2017-06-20
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Marashi, Bonnie
Brian Smith
B: 1963-05-14
D: 2017-05-20
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Smith , Brian
W. Terry
B: 1930-07-07
D: 2017-05-10
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Terry, W.
Patsy Smith
B: 1950-12-07
D: 2017-05-05
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Smith, Patsy
Billie Ruth McKinnon
B: 1933-10-21
D: 2017-05-02
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McKinnon, Billie Ruth
Carol Buckins
B: 1947-07-04
D: 2017-04-30
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Buckins, Carol
Bernice Peoples
B: 1938-10-19
D: 2017-04-30
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Peoples, Bernice
Tammy Smith
B: 1968-07-19
D: 2017-04-25
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Smith, Tammy
Merle Kelsoe
B: 1932-08-17
D: 2017-04-24
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Kelsoe, Merle

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15215 Court Street
Moulton, AL 35650
Phone: (256) 974-0621
Fax: (256) 974-0644

Immediate Need

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

To report a death to Elliott Brown-Service Funeral Home, please notify us first by phone at (256) 974-0621.

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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