| Name | Edward Jack Bloom |
|---|---|
| Sex | male |
| Birth Date | November 8, 1890 |
| Death Date | January 22, 1981 |
| Age at Death | 90 years, 2 months, 14 days old |
| Birth Place | Ohio |
| Death Place | Shasta County, California |
| Mother's Maiden Name | Williamson |
| Social Security Number | 566-12-4947 |