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Name: Wilhelmus Adr. van Bergen
Date and place of birth: 20 November 1906
Original address: Cronjéstraat 17 b, Rotterdam
Occupation/profession: Scheepsbouwer, -
Status identity card: echt
Ground for hiding out: anderszins
Hiding address: Sperwerstraat 23, Leeuwarden
District of the LO: Leeuwarden
Caretaker: - Brouwer
Goed PB, geen stkrt.
Achterkant beroep: Scheepsbouwer
Achterkant naam werkgever: -