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Name: Johannes Lodewijk v. Apeldoorn
Date and place of birth: 26 January 1882, Enter (O)
Original address: A 44, Boornbergum
Religion: Nederlands Hervormd
Occupation/profession: Predikant
Identity card: geen
Ground for hiding out: anderszins
District of the LO: Drachten
Other remarks Bijzondere opmerkingen: Formulier is ondertekend door ??? voor Ds. v. Apeldoorn