| Street | 1121 E Miller St | ||
| City/Town | Jefferson City | ||
| State/Province/Region | Missouri | ||
| Zip/Postal Code | 65101 | ||
| Phone Number | (573) 635-7765 | ||
| Country | United States |
| Full Name | Bertha Ward | ||
| Gender | male | ||
| Birthday | 1987-05-18 | ||
| Social Security Number | 518-89-4463 |
| Credit card brand | Mastercard | ||
| Credit card number | 5307756436154336 | ||
| Expire | 2030/1 | ||
| CVV | 867 |