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Name: Thomas Antonius Edelbroek
Date and place of birth: 28 September 1889
Original address: Sibrandus Leostraat 4, Leeuwarden
Occupation/profession: arbeider, N.S.
Status identity card: gewijzigd
Ground for hiding out: staking
Hiding address: Minnertsga
District of the LO: Leeuwarden
Caretaker: van der Steeg
gew. pap.
Achterkant beroep: arbeider
Achterkant naam werkgever: N.S.