Jeremiah Alan Smith

DEATH NOTICE FORM FROM: NEWCOMER FAMILY FUNERAL HOME
TOPEKA, KANSAS

Family contact name and telephone number: Mark Smith 785-273-0484 (Father)

1. Full Name: Jeremiah Alan Smith Age: Stillborn Sex: Male

2. Current address: of Topeka

3. Date of death: , October 5, 2002

4 Place of death: Topeka local hospital

5. Cause of death:

6. Date of birth: October 5, 2002 Place of birth: ,Topeka

6.b. Parents: Mark A. Smith and Kerri F. Jones

6.c. Years in current city/town:

7. Background:




8. Relatives:
8.b. preceded in death by:
8.c. Immediate survivors:
Parents, Mark and Kerri of Topeka KS; Grandparents: Jeff and Donna Smith of Topeka, KS; Great-
Grandparents: Jack Herron of Junction City, KS. and Geraldine Smith of Roslyn, New York;


9. Service time, day, date, place: Services will be at 11:00am, Friday, October 11, 2002 at Quivira
Heights Church of Christ.

10. Burial: Will follow at Mt. Hope Cemetery ,

11. Visitation times, place: Jeremiah Alan Smith will lie in state at the church where the family will receive
friends from 10 to 11, time of service .

12. Vigil, wake, rosary, other: None
13. Memorial contributions, if any: None


14. Funeral home in charge: Newcomer Family Funeral Home, 4020 SW 6th Ave., Topeka, Kansas 66606
Director: Sue Brueggemann