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Obituary Form

You can supply the Daily Union with the information regarding an obituary by filling out the online
form below, or by filling out a paper form and mailing it to the Daily Union at the address above.
Obituary forms for printing can be downloaded here.

OBITUARY FORM
Daily Jefferson County Union
28 W. Milwaukee Ave., Fort Atkinson, WI 53538
Phone: (920) 563-5553 • Fax (920) 563-2329 • Email: mwagner@dailyunion.com

GENERAL INFORMATION

No obituaries or death notices will be accepted without a contact person's name, phone number, e-mail address and billing address. The person submitting the information must call the Daily Union at (920) 563-5553 to confirm the information before the obituary or death notice will be printed in the paper.

Use complete names (no nicknames). Do not abbreviate names, degrees, states, employers, etc. Incomplete and/or illegible information will be omitted. The Daily Union reserves the right to edit submitted information. If you wish to include a photograph, please send it to the Daily Union at the address above. Photographs will be mailed back if a name and address is printed on the photo back. Photographs may also be e-mailed as attachments to the e-mail address noted above on this page. If using a digital photograph, optimal resolution is 300 dpi or higher.

The Daily Union charges $5 per column inch for its obituaries. Charges are available by calling (920) 563-5553 after 10:30 a.m. the day following publication. A death notice will be printed at no charge. To run as a death notice, only include the name and age of deceased, where they lived and when they died and funeral service arrangements.

Name of deceased
Age
City and state
Died when
Died where
Date of birth
Place of birth
Parents

Schooling
Occupation

SURVIVED BY

Husband    Wife

Number of children

Names of children





Number of grandchildren

Names of grandchildren





Other relatives





(note relationship)


Contact Information

Your name
Phone Number
E-mail address*
Billing Address

*Return e-mail address is required in order to verify your submission. Submissions that cannot be verified will not be included in the newspaper.


Date and time of service
Location
Officiant
Place of burial
Date and time of visitation
Location
Memorials made to
Memorial poem/verse

Church membership
Organization memberships

.

Spouse's Name

Number of great-grandchildren

Names of great-grandchildren





Number of brothers & sisters

Names of brothers & sisters





Preceded in death by






Photograph to be included?

No      Yes