| Street | 643 W Liberty St | ||
| City/Town | Medina | ||
| State/Province/Region | Ohio | ||
| Zip/Postal Code | 44256 | ||
| Phone Number | (330) 722-5051 | ||
| Country | United States |
| Full Name | Clint Jacobson | ||
| Gender | male | ||
| Birthday | 1989-12-29 | ||
| Social Security Number | 402-73-9021 |
| Credit card brand | Diners Club | ||
| Credit card number | 3006114601700724 | ||
| Expire | 2027/12 | ||
| CVV | 819 |