| Street | 5811 N High Cross Rd | ||
| City/Town | Urbana | ||
| State/Province/Region | Illinois | ||
| Zip/Postal Code | 61802 | ||
| Phone Number | (217) 643-7847 | ||
| Country | United States |
| Full Name | Andreane Grimes | ||
| Gender | female | ||
| Birthday | 1977-07-21 | ||
| Social Security Number | 511-33-9343 |
| Credit card brand | American Express | ||
| Credit card number | 341842601239703 | ||
| Expire | 2031/4 | ||
| CVV | 902 |