| Name | Jack William Bergendahl |
|---|---|
| Sex | male |
| Birth Date | January 26, 1922 |
| Death Date | April 11, 1980 |
| Age at Death | 58 years, 2 months, 16 days old |
| Birth Place | Illinois |
| Death Place | Marin County, California |
| Mother's Maiden Name | Hall |
| Social Security Number | 473-12-7520 |