| Street | Krapkowicka 8A | ||
| City/Town | Opole | ||
| State/Province/Region | Opole | ||
| Zip/Postal Code | 46-020 | ||
| Phone Number | 77 457 47 71 | ||
| Country | Poland |
| Full Name | Kazimierz Chmielewski | ||
| Gender | male | ||
| Birthday | 1974-04-03 | ||
| Social Security Number | 03241138622 |
| Credit card brand | JCB | ||
| Credit card number | 3563362817338731 | ||
| Expire | 2029/8 | ||
| CVV | 539 |