345 Date.....B.ep.t.emb.e.r.....9+._.l9.59

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FUNERAL RECORD OF

No•....... _.._.. _.. ______

Yearly

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.............Age........................... .3........................................... _....... (Years) (Months) (Days)

How Long Resident in Community..........................................._........... _......................._.......................................... . Single ........................Married. ....................... Widowed ....................... Divorced...................... Child ......... .c.P.:l),Si.. . Husband, Wife or Child of..................Ii.lf.r.e.d... ChaJlljuuL........................................................................... Address................................._ .............................E;1l;~.1;.~.r.......M~!?..!?g.~F..~................:....................................... .. Closest Relative._....Alf.r.ed...Ghapman .........................Address................................................................ .. Father's Name.....Alf.t:e.d...Ch.ap.!!!an.............................Birthplace..............,............................................... Mother's Maiden Name......Ma;t?y.....M. •... Nunn.~irthPla~:.. ~.~ ..... . Cause of Deatb?2u.l.a~~~..................con~utory....8.:.2rj ... Date of Death.....J~J~p.J!.~!!!!?.~E.... Hour.................~.:.?2 ~ Place of Death.................. D.Q!!!tL ..............................................How Long Ill ?.................................................... . Physician .......J2r.:.:.....9.g~.§ ~ ~ ~:r:.~.~.~ Address ............g.a.§.il.Y..1.l..l~ .......M.1..!Hl.Q.\!.ri Occupation of D.ceased............Qh..tld. ................................... Social Security No ............................................ .. Name of Employer................ __ .... __................... _..._........................................~................................................... :.......... . Address ............................................................................................................................................................................. . Charge to................................. _.................................................... _.A.ddress .................................................................. . Order Given By...............................................................................Address........................................... _.................... . Date of FuneraL ......-S.ep.temher. ...ll......19.59..........Time ........................2.. J'....M.?........................... .. Pl.ce of Funeral Service..._........ _.... -C.ul :lr.e.I!.!.s ....Ghap.e.L ....................................................................._. Clergyman....... Rev......Hugh...HiggB................................ Call for? ............................................................._

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Total AmounL ............................... - - - -_ Remains to be shipped-see reverse for details.

Interment at................Mapl.el'.lQOd...c:~meter.,jL .........................................................................................

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S UPERIOR FUNERAL SUPPLY CORP • • CLI:VEUHD, OHIO.

Information Given To: Relatives Musicians

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FUNERAL · RECORD OF Yearly No...............l

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Date of Birth...... .J.a.n.uar.Jc..2.l.~...l

8.S.1..............Age.............1 ;;;.............................................................. (Years)

(Months)

(Days)

How Long Resident in Community........................................ __ ._ ........... _.................................................................. . Singl .........................Marri.d. ....................... Widowed ....................... Divorced.9J,Y..Q.r.Q.ltli\ild ........................... . Husband, Wife or Child of........................................................................................................................................... . Address ..................................................._ ....................................................................................................................... . Closest Relative......Mr.s._ ...F.r.ank.... F.Q~.......................Address.....~!?,gJ.~....R.Q.Q.K•....M~~u?.Q.~.r. i Father's Namea.J-~.;k.1Y1..c-.n.~ . 1r!<.u.d~.t .Birthplace............................................................. .

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Mother's Maiden Name..E~~....

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Charge to...............

Order Given By............. §.:i.!:l.~ .~.r..I? .......................................... .Address................................................................. .

Date of Funeral... ... Sep.t.emb.e.r. ... l .1.•....1 959..............Time............. 2... P...•.M. . ........................................

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Place of Funeral Service............ .(;~.l.v-@.,.!.g.. ..Q.hap.el ................................................................................ . Clergyman...... Re.v..~....Ch a.s. •.... Y.a.n.z.a.n.dt..................... Can for? ................................................................

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Credit

Remains to be shipped-see reverse for details.

Interment at............... .G.ar.inth. ...C.erne.t ..

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Lot No ............................................. Section No ............... _......... ;~ ................. Grave No .............................................. .

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Singers

Pennit Bill Rendered

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FUNERAL 'RECORD OF Y.arly No............ ~.QJ.. ..................

No ........................_ . _ _

Name. ..........................................Vlil liam....T..l.l!ien...I3.Q!.'!.!!Ian............................... Sex. ...........I!:\?c;!,§!...... Addres ..................................................~~l!?r. .......M~&.~ .().~.~.~.......................................................................... COunty........~!a,.r.r.Y.....................TOWD8hip .................................................. Phone No ............................................. Wh.re BOrD...............Bar.r.y....G.o.ut.Uy.......M.1..
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Date of Birth. ....... .E'.ehurary. ....9.....J.8.11............. Ag.................... (Years)

(Months)

(Days)

..........................................................................................

How Long Resident in Community...... l~,J·.~....t~.!!!~ Singl. ........................Married... marr.iedvidowed.......................Divorced...................... Child .......................... .. Husband, Wile or Child oL ........................ Gr.a.c.e. ... .8mitb. ... .I3.Qlmllan.................................................... .. Address ........................................................................Exe.t .er., .... .Mis..sQ.tlr.L ............................................... .. Closest R.lativ....... 2.r i)...C ~....!2.()!'!!P.§:!),................................Address ................................................................ .. Father's Name...G.e .Q.r.g§.. .. yf..,.....l?.9..w.!)!.\lc!} .........................Birthplace............................................................ .. Mother's Maiden Name.......laUr.a...I3.e.l.l.... B..rai;.:t:),))!irthpl~ce............................................................ ..

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............. / Casket ......& ...C.....Eox...................... .. (Style) (No.)

Outside Case or Vault..... __ ............. ____ .____ . Embalming Body .................................... .. ·.... ·.... 1 Professional Service ............................... . .. .......... / Hair Dresser............................................. . Suit or Dress ........................................... . Shirt, Collar, Tie..................................... . ............ , Shoes $...................... Hose $.......:............. . .. .......... 1 Underclothes ............................................ Door Spray ................................................

Gloves $.................... Chairs $................... . $.................. Palms $................. . r;remation .................................................. Ne'wsj)aper Notices .................................. . ,Teol.phoIl. and Telegraph....................... .

.. .. · .... •.. 1 Flowers

Coach ........................................... . pailS eng'" Cars ........................................ ..

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Bearers' Service ............................... .

Place of Death... s.al..e..$. ...Ml').m9..r J.§,.1.....!!9..~p...:............lIow Long Ill? .................................................. ..

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Occupation of Deceased...far.me.r........................ _.............. _Social Security "0 ..........................................,

Cemetery Charges ................................... .

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Missour i

Lot ............................................................. .

Name of Enlpl.,y,,,............................................................................................................................................................1

Misc. Transportation............................... . Shipping Charges .................................... Clergyman ............................................... . Singers $................ Organist $................. . Cash Advanced ......................................... .

Charge'o....... ,~~,~,<~ ....................................................................... _aa.oress ....................................................................... ~ \ Order Given lSy............. "". ..W".ViC............., ... : .......::..::.:=.=.................Ad,dre'ss................. ;" ...;;.:....,.; .... .. !'-Q,'.....~7.2)~ ................J~im'e...................... 7. .. ~. ~

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-""..·1 ..................................................................... . Total Amount.................................. - - - ,_ Remains to be shipped-see reverse for details.

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Casket Mfg. Co.

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FORM !Sass SUPERIOR FUNERAL SUPPLY COR .... CLBVELAHD, O HIO.

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Information Given To: Relatives Musicians

Death Certificate Payment Arranged

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Attended To:

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Permit Bill Rendered

Insurance........................................................................................._

Date. ..8.ep.temhfU:.2Q,.._.125~ERAL

348 CHECK EACH ITEM AS COMPLETED

RECORi> OF C

Yearly N 0 .... _ ......),.9.$....... _......_...

N 0 •.......... . _ .••... _ ••_ •• _ •• _ _

.............

Name. ......_........ _............ _..........Char.le.s....AQ.e ....Sne_th.e.!l..................................... Se>:.....~J~

Address....... _........................ _....... Q.a.~J2yJ)),.I2...... M.~§.§g.~.~.1........................................................................ COunty........B.ar.r.Y-.._....__._..Township..........._.... _... _...........................Phone No ............................ _.............. .

g..emy_~r.,.....~@.§.f!._~_ ...._........ _.................Race...........':!J:l.?:~.~...................... of Birth. .............. F..e.br.uary....2.S.. .....la1.2... Ag....................I!!.7.. ............. _.........................................

Where Born............C.lal'....

Date

(Years)

(Months)

(Days)

How Long Resident in Community............................................................................................................................ . Single.6.1.ngl.e.....Marri.d. .......................Widowed.......................Divorced...................... Child .......................... .. Husband, Wife or Child of............................................._............................................................................................ . Address ............._.._..__......._ ................_..........._........................................................................................................... . Closest R.lativ.....J.o.e.._D.a,v.alllt....._...............................Address ......... J?P.r..*P.-.g;+.J.I2.;!,g,~.....M 9..,...... Father's Nam._.._._.liC ___..S-._.Snath.en.... _........... __ .. _.. _.....Birthplace_.. _.............._...........__ ._ ..... _.................... . Mother's Maid.n Name._.J,.)Jg.;:L.Amt....TI!:!?:Y..~T ............Birthplace..._......................................................... Cause of Death........ -Gll,X
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.2.If......J...95.9.............Time.........................?... ~..~.r.i.~.............................

Date of FuneraL ..... 5ep.t .emb.e.r...

C.sket ........................................................ $.................. (Style) (No.) Outside Case or Vault........................................... : ..... . Embalming Body ...................................................... .. ............ , Professional Service .............................................. .... .. ............ Hair Dresser .............................................. .................. .. Suit or Dress .............................................................. .. Shirt, Collar, Tie...................................... ................... . Shoes $....... _.............Hose $...................... .................. .. Underclothes ............................................ .............. .... .. Door Spray .................................................................. .. Gloves $.................... Chairs $............................... _...... . Flowers $.................. Palms $.................................... .. Cremation ..................................................... _............. .. Newspaper Notices ................................................... _. Telephone and Telegraph...................................... .... .. Ambulance ................................................ ................... . Funeral Coach ............................................... _............. .. Passenger Cars............................................................ .. •........... Pall Bear er s' Service............................... . ............ Transferring Body............. _.................... . Opening of Grave.................................... .. Cemetery Charges .................................... I Lot .............................................................. Misc. Transportation................................ I Shipping Charges .................................. .. Clergyman ....................... _....................... Singers $................ Organist , ................ .. Cash Advanced ........................................ .. 1

Place of Funeral S.rvice............. ..Baldl&i.n_.c.1.t~....C..eme.t..e.J;X.......................................................... _. Clergyman........._.............. __................_...................... :.................. Call for? ............................................................._ Address........... _............................_...._................ _ .._.... ~.........: .........:._...............~............................................_.. _.._.._.

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Remains to be shipped-see reverse for

Total Amount................................ ..

d~tails.

Interment at....... _..BaldlMin •._.KaU.a,aS.......................................................................................................... Lot No .................... _... _.................. Seetion No ............... _............................ Gi-ave ·No .............................................. .

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.................................. EEg.n~lJ.~...!~.rg.~....g.'?.~.... _............_.._......................................... ............................... FORM 82.S8 S U PERIOR F U NERAL SUPPLY CORP • • CLEVELAND. OHIO.

Information Given To: 0 Relatives 0 Musicians

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Attended To:

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OPEl

OBI

..28._.19 59

Date. .. J3.ep.te.mb.e.r. ..

FUNERAL ·.RECORD

CHECK EACH ITEM AS COMPLEI'ED

OF Yearly No ..................1.Q9..............

No ............................... _ _

Casket

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Outside

Address .....................~}2....W.e.s..t....chur.c h ... .s.tr.ee.t .".Aur.Q.~a... ....M:!.l?..§.Q.ldr.J...........................

Embalming Body ................................... . Professional Service ............................... . Hair Dresser............................................. . Suit or Dress ............................................ , Shirt, Collar, Tie ...................................... I

Where BOl'lL ......................K.ent.lJQ!\.Y.......................... _ .................................Race .........Y'.~.! .~.~ .......................

?!±......l?!.2.Lt...........Ag......................?5.........................................................

Date of BirtIL.. EaQJ.l..r..Y.
(Years)

(Months)

(Days)

Gloves $.................... Ch.irs $.................... . F lowers $..................Palms $.................. . Cremation .................................................. . Newspaper Notices ................................. .

Telephone and Telegraph...................... ..

Place of Death.......AUJr.O.r.a...H.QJ3P.J.1i.al.......................How Long Ill? ................. I±....~y.~ .~¥.~ ............. Physician.. ~.!. ... M~.9.~.~.~~n.!.............................. Address ........~':l:r:?:.I3:., ~?. Occupation of Deceased. ..... .b.o.USel!li .t:e........................... Social Security No .......lJ:9.6:~.;),.~.3.Ql.6.. ..

Ambulance .............................................. .. Funeral Coach ........................................... . Passenger Cars .......................................... Pall Bearers' Service ............................... . ............ Transferring Body................................... . Opening of Grave............................... _... .. Cemetery Charges ................................... .

Name of Employer..... __ .............................. _..... _... __............................................................................ __._______.. __ ........... .

Lot ..............................................................

....

P..r...:....

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..............................

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Misc. Transportation ............................... .

Address ....................................................................._...... _...............................................................................................

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Cash Advanced ..........................................' .. ..(?i!,;!,~.§.... r..
..................................

.............................. . . . ................... ................. 1

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Interment at............ Ei

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Lot No ........................... _..._........... Section No ............................................Grave No .......................~.......................

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Father's Namg.a.me-&.. ~~ma,S...C=.b.1.r.I ....................Birthplace.............................................................. Mother'. Maiden Name.........lCUl,.. .A.l le.n ............................Birthplace.................:.......................................... .. Caus. of Death...... .Hy.p..QJtl<5',.);J9.... P..!!~1l.1P.~.g.*.~........Cont;ibutory.......................................................... Date of Death......(?~H~.:!;.~..m.1?~.~ ?.el.l.... .Hour....................~.? ::.o..o..~

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How Long Re.ident in COmmunity................ lD.ontlliL .......................................................................... .. Single........................Married..... [email protected].~dowed.......................Divorced...................... Child.......................... .. Husband, Wite or Child of.............................QJ:!Y..~!.: .. X~.~~~.!Y.: Addres.............._ .............._ _ ............................. Allr.or.a ...... Ml,a.s .o.ur1....................................................... . Closest Relativ.......Al:ma...Mae. ... Enf.le~d ....................Address ...........C. a.§.§.y..1J.!.~.J. ....M;!,§,.§.Q.hl.r i

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35 0 Date.Sep:t.e.mb.e.r....3.Q....J359 . . FUNERAL RECORD OF

CHECK EACH ITEM AS COMPLETED Y.arly No .... _......_....ll..Q_......_...

No........ _.............._.._.._ _

Name. ...... _........ _............_.. Sa~...G.ene:u-a....(Ne.v.a.).... ahan.o.w.iI:tb.............Se.x....... t:e.mle.....

Addr..s ................................. _......Wh.eat-on.,. ....Mis.8.0.uri............................................................................ .. County ...... Ea.:r..:r:Y............._.._...Township....... _............ _...........................Phon. No ............................ _............. .. Where Born. ............Whea.t .Qn..... M.ls..(lQ_v...;r.~ ..... _ ...._........_.................Rac..........w.hg.~........................

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.._.l~~J..............Age........._........... ..7.9........................................ ,..._....... (Y.ars) (Months) (Days)

Date of Birth.......Q.9..t.Q.p..e.:r..... n~

How Long R.sid.nt in COmmunity...........1U.e....time ... _........... _................................................................... Singl.........................Marri.d. ....................... Widow.d....y!.),9:.9..W.~fuvorc.d...................... Child.......................... .. Hnsband, Wite or Child oL ........_................... '1L....Q......Qb..enQlIl.e.t.b. ...................... _.................. _............... Address.............__..... _. __ ._ _.. _.... _...... _....................................................................................................................... ..

r.c.ar.:r.oZlll.Ch.enQlIl.e.J;h_....__.Address_.Q.
Closest R.latiVe...... Fath.r's Name....... _ ... .. Mother's Maiden N

{;L.... '::'L~Aa2..!..:._.. _.....Birthplac...._......................................................... e...._. e .,.~....~~:21~rthPlace_.. __ .~ __ ................................................... .

Death._J..l~<....-.aC2............................................Contributory............................ __ .... _____ .____________ ._.., Death... _....Sep.t .amb.e.r....}O'......1.959.... ........... .Hour......... :..............................................................

Cause of Date of

Plac. of Death .............hO,llls.................................... _...............How Long Ill ?..................................................... Physician............j).r... ...,M""r.;y... N.elllmaIl.............................. Addr.ss ...........C.a.(l.s.1l.;\...lJ.e.~.....MQ.............. Occupation of D.c.as.d. ....... J:.l'O.uJ>.ew.1t:.e........................ Social S.curity No ............................................. . Name of Employer __ ..__ ..................................... _... _..................................................................................................... .. Address ............................................................................................................................................................................. .

Charge to ...........ch.i.ldr.en ...........:...................................... ...Addr.ss ............................................. _.................... Ord.r Given By............... .ch.il.dr.en.....................................Addr.ss................. _........................ _.................... . DateofFuneraL ........ U.I;X.Q:lel~....~7..... JL~:~~,

. . . . ............

jrim. ~ .......... '~ ..

.Jr.•.AW." ....................:

Place of Funeral Selrvi"e.............. _....Yil~e.a.1"Q.n...J:i,5I.ll'.J;.;~.(l.]i.....~jlJ.lJ.:~m ...................:

Cl.rgyman...... Sller"..QQlI.Ien"'R1.char.d.(lQD. .......... Call for 1.. ................ ..

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D

Remains to be shipped-see reverse for details.

Intermen t aL .... _........_...MlID.C.J!_.. Ql:l.
J.:..chJ.~.!!!~.~~.....@..£?Q..~.!L ..C..Q.P.p..e...:............ ....... W hite duchess crepe interio r ................................................................................ _.......................................................................................................... .

Ramarks ....................... _.. ..2MQ .. ..!1.8 ... g.a ..

.....................................................§p.±..j,!}g.f..~~.1..d.:.. g~.~.~~.~

....~.:f.~........g?.. ~.............................................

FORM l5aal5 SUPERIOR FUNERAL 8UPPLY CORP.. CL EVELAN D , OHIO.

Casket & ....a.er.v.l0..e.s. ....................... .. (Styl.) (No.) Outside Case or Vault............................. . Embalming Body .................................. .. Professional Ser vice .............................. ..

~:i~ o~r~~::~:; :~~:::: Shirt, Collar, Tie ..................................... . Sho.s $....... _............. Hos. $.................... .. Underclothes .......................................... .. Door Spray .............................................. .. Glov.s $....................Chairs $..._.............. . Flow.rs $..._.............Palms $................. . Cremation ................................................ .. Newspaper Notices ............................. _... T.l.phone and Tel.graph..................... .. Ambulance ............................................... Funeral Coach .......................................... .. Passenger Cars ........................................ .. ............ Pall Bearers' Service.............................. .. ............ Transferring Body.................................. .. Opening of Grave.................................... .. Cemetery Charges ..................................., Lot ............................................................. . Misc. Transportation ............................... . Shipping Charges ................................... . Clergyman .............................................. .. ............ Singers $................Organist $................. . Cash Advanced ..........................................

Sale.E....Tax ......................................... ..······ ..·......•....··......··· ..........·......·· ....·.. ·.. ··· .. ···11