| Street | Ostrozna 12 | ||
| City/Town | Opava | ||
| State/Province/Region | Moravian-Silesian | ||
| Zip/Postal Code | 746 01 | ||
| Phone Number | 553 730 268 | ||
| Country | Czech Republic |
| Full Name | Anežka Boučková | ||
| Gender | female | ||
| Birthday | 1971-06-12 | ||
| Social Security Number | 258-53-4719 |
| Credit card brand | Diners Club | ||
| Credit card number | 3016180697279202 | ||
| Expire | 2030/9 | ||
| CVV | 549 |