| Street | Jalan R. W. Monginsidi | ||
| City/Town | Kupang | ||
| State/Province/Region | Nusa Tenggara Timur | ||
| Zip/Postal Code | 85001 | ||
| Phone Number | (0380) 831374 | ||
| Country | Indonesia |
| Full Name | Utama Cakrabirawa Siregar | ||
| Gender | male | ||
| Birthday | 1985-02-27 | ||
| Social Security Number |
| Credit card brand | Discover | ||
| Credit card number | 6011129173499303 | ||
| Expire | 2029/3 | ||
| CVV | 263 |