Southern Hills District UMW
Deceased Members Report Form
..................................................................................................................
Please print the name or names of the members of your unit who were called home in the
year 2008.
Unit Name __________________
Person making this report _______________ Phone _______________
NAME_________________________________
NAME_________________________________
NAME_________________________________
NAME_________________________________
NAME_________________________________
**Important**
PLEASE RETURN THIS FORM WHETHER YOUR UNIT HAD ANY DECEASED MEMBERS OR NOT.
MAIL TO: Amy Mikes BY: April 1, 2009
107 Short Street
Byesville OH 43723