Obituaries

Mohamed Raffie
B: 1958-01-01
D: 2020-10-12
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Raffie, Mohamed
Thelma Marajh
B: 1937-02-11
D: 2020-10-12
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Marajh, Thelma
Terence Persaud
B: 1965-09-01
D: 2020-10-07
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Persaud, Terence
Gangadaye Maharaj Dookie
B: 1962-06-02
D: 2020-09-29
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Dookie, Gangadaye Maharaj
Ann Marie Dewitt
B: 1960-12-10
D: 2020-09-26
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Dewitt, Ann Marie
Surjit Kaur
B: 1941-06-15
D: 2020-09-25
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Kaur, Surjit
Regina Smith
B: 1958-07-01
D: 2020-09-24
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Smith, Regina
Gurnam Singh
B: 1957-02-10
D: 2020-09-23
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Singh, Gurnam
Mark Lutz
B: 1958-07-29
D: 2020-09-22
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Lutz, Mark
Sukhnanand Lall
B: 1947-04-18
D: 2020-09-19
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Lall, Sukhnanand
Thora Barnes
B: 1936-03-26
D: 2020-09-17
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Barnes, Thora
Rampeearie Baboolal
B: 1935-01-12
D: 2020-09-04
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Baboolal, Rampeearie
Hardev Kaur
B: 1928-01-01
D: 2020-09-03
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Kaur, Hardev
Marva Perry
B: 1950-07-15
D: 2020-08-27
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Perry, Marva
Helen Elcock
B: 1934-01-01
D: 2020-08-20
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Elcock, Helen
Tyrone Bundrige
B: 1958-10-12
D: 2020-08-20
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Bundrige, Tyrone
Carmen Roberts
B: 1934-02-05
D: 2020-08-20
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Roberts, Carmen
Ivin Shirley
B: 1960-09-08
D: 2020-08-19
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Shirley, Ivin
Banta Singh
B: 1931-09-02
D: 2020-08-17
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Singh, Banta
Eugenio Cabezas
B: 1956-02-19
D: 2020-08-16
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Cabezas, Eugenio
Raman Kumar
B: 1982-01-07
D: 2020-08-16
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Kumar, Raman

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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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