| Street | 13356 Bass Lake Rd | ||
| City/Town | Maple Grove | ||
| State/Province/Region | Minnesota | ||
| Zip/Postal Code | 55311 | ||
| Phone Number | (763) 551-9999 | ||
| Country | United States |
| Full Name | Maximillia Nicolas | ||
| Gender | female | ||
| Birthday | 1978-11-26 | ||
| Social Security Number | 444-27-2735 |
| Credit card brand | Discover | ||
| Credit card number | 6011044091891087 | ||
| Expire | 2031/4 | ||
| CVV | 802 |