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Name: N. Bloemendaal
Date and place of birth: 8 October 1902, Leeuwarden
Original address: Moleneind Noordzijde 18, Drachten
Occupation/profession: Oorspronkelijk jeugdleider, Dep. v. Soc. Zaken
Identity card: echt
Ground for hiding out: jodenvervolging
District of the LO: Drachten
Other remarks Bijzondere opmerkingen: Financiële steun door ill. 'A.J.C.'