| Street | 1-4 Okinohama | ||
| City/Town | 坂出市 | ||
| State/Province/Region | 香川県 | ||
| Zip/Postal Code | 762-0044 | ||
| Phone Number | 0877-45-7366 | ||
| Country | Japan |
| Full Name | 小泉 七夏 | ||
| Gender | female | ||
| Birthday | 1973-05-13 | ||
| Social Security Number |
| Credit card brand | JCB | ||
| Credit card number | 3568390132568372 | ||
| Expire | 2031/3 | ||
| CVV | 901 |