Obituaries

Janice Ryan
B: 1927-08-29
D: 2017-04-23
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Ryan, Janice
Gerald Whitlow
B: 1940-08-08
D: 2017-04-20
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Whitlow, Gerald
Barbara Bieser
B: 1932-02-17
D: 2017-04-19
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Bieser, Barbara
Virginia Richter
B: 1922-10-22
D: 2017-04-16
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Richter, Virginia
Kenneth Powers
B: 1952-06-23
D: 2017-04-15
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Powers, Kenneth
Elva Bair
B: 1919-07-26
D: 2017-04-14
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Bair, Elva
Dorothy Whiton
B: 1949-08-07
D: 2017-04-12
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Whiton, Dorothy
Richard Faigle
B: 1943-02-20
D: 2017-04-08
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Faigle, Richard
Jacqueline Stack
B: 1930-07-25
D: 2017-04-07
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Stack, Jacqueline
Clyde Robbins
B: 1931-07-21
D: 2017-04-07
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Robbins, Clyde
Judith Rogers
B: 1946-01-12
D: 2017-04-05
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Rogers, Judith
Jerry Brown Sr
B: 1941-03-14
D: 2017-04-04
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Brown Sr, Jerry
Mary Pohlman
B: 1933-02-21
D: 2017-04-02
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Pohlman, Mary
Mary McCallister
B: 1938-05-13
D: 2017-04-02
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McCallister, Mary
Gail Malter
B: 1951-06-08
D: 2017-04-02
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Malter, Gail
Wanda Thomas
B: 1930-07-15
D: 2017-04-02
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Thomas, Wanda
Jack Tipton
B: 1923-12-31
D: 2017-03-27
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Tipton, Jack
Harry Modglin
B: 1949-03-21
D: 2017-03-26
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Modglin, Harry
Linda Raymer
B: 1945-02-09
D: 2017-03-23
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Raymer, Linda
Cynthia Rivers Harris
B: 1949-06-17
D: 2017-03-20
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Harris, Cynthia Rivers
Cecile LaSurs
B: 1916-03-22
D: 2017-03-19
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LaSurs, Cecile

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501 West Main Street
Collinsville, IL 62234
Phone: (618) 344-0187
Fax: (618) 345-4377

Immediate Need

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

To report a death to Herr Funeral Home & Cremation Services, please notify us first by phone at (618) 344-0187.

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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