| Street | ulitsa Chapaeva (Smolinskiy), 114 | ||
| City/Town | Челябинск | ||
| State/Province/Region | Челябинская область | ||
| Zip/Postal Code | 454082 | ||
| Phone Number | 8 (351) 729-82-29 | ||
| Country | Russia |
| Full Name | Фомина Клара Фёдоровна | ||
| Gender | female | ||
| Birthday | 1975-08-13 | ||
| Social Security Number | 490565211144 |
| Credit card brand | American Express | ||
| Credit card number | 378071995044273 | ||
| Expire | 2027/7 | ||
| CVV | 262 |