| Name | Laverne Lynn Forman |
|---|---|
| Sex | male |
| Birth Date | April 17, 1910 |
| Death Date | March 4, 1991 |
| Age at Death | 80 years, 10 months, 15 days old |
| Birth Place | Iowa |
| Death Place | San Mateo County, California |
| Father's Last Name | Washington |
| Mother's Maiden Name | Wiseman |
| Social Security Number | 563-12-1226 |