Watertown Daily Times Obituary Form
Send to: Watertown Daily Times, 260 Washington St., Watertown, NY 13601 Phone: (315) 782-1000; Fax (315) 661-2523
Name, age and most recent address of deceased: ------------------------------------------------------------------------
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Date of death:
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Place of death (indicate length of stay at hospital or nursing home):
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Name and town/state of hospital or nursing home:
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Cause of death (required if under age 60):--------------------------------------------------------------------------------
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Date and place of birth, parents' full names:
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Education: ------------------------------------------------------------------------------------------------------------
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Military service, dates of service, medals earned: ------------------------------------------------------------------------
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Marriages, (names and dates; indicate if divorced, separated or deceased): ------------------------------------------------
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Career or employment outline:
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Memberships:
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Civic contributions: ----------------------------------------------------------------------------------------------------
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Unusual hobbies or interests:
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Survivors, (relationship, name, place of residence):
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Predeceased, (relationship, name):
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Funeral, memorial or graveside service (time, date, place): ----------------------------------------------------------------
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Clergy, (name, title, church affiliation):
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Burial, (name of cemetery, location) or cremation: ------------------------------------------------------------------------
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Calling hours, special services, (time, date, place Contact numbers: family, funeral home.
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Name and location of funeral home (required for purposes of confirmation):
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August 7, 2002
