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Name: Frederich Otto Bevensee
Address: 1410 Springfield Ave., Irvington, Essex, NJ
Mailing Address: Same
Age: 45 years
Date of birth: December 5, 1896
Place of Birth: Newark, New Jersey
Name and address of person who will always know your address: Tillie Bevensee, 1410 Springfield Ave., Irvington, NJ
Race: White
Employers' Name and Address: Public Service, 80 Park Pl, Newark, NJ
Race: White
Height: 5' 9"; Weight: 140; Color of Eyes: Brown; Color of Hair: Black; Complexion: Ruddy