| Street | 1 Chome-3-6 Hamasaki | ||
| City/Town | 朝霞市 | ||
| State/Province/Region | 埼玉県 | ||
| Zip/Postal Code | 3510011 | ||
| Phone Number | 048-486-0850 | ||
| Country | Japan |
| Full Name | 佐々木 直樹 | ||
| Gender | male | ||
| Birthday | 1991-05-28 | ||
| Social Security Number |
| Credit card brand | Unionpay | ||
| Credit card number | 6234868015087492 | ||
| Expire | 2029/3 | ||
| CVV | 639 |