Name: Jan Douma
Date and place of birth: 14 May 1887
Original address: Engelumerstraat 58, Leeuwarden
Occupation/profession: Adj. Commies, Nederl. spoorwegen
Status identity card: vals
Ground for hiding out: staking
Hiding address: Nieuwestad 75, Leeuwarden
District of the LO: Leeuwarden
Caretaker: Bijlsma

Other remarks Achterkant beroep: Adj. Commies
Achterkant naam werkgever: Nederl. spoorwegen