| Street | 1450 Broadway St | ||
| City/Town | Eureka | ||
| State/Province/Region | California | ||
| Zip/Postal Code | 95501 | ||
| Phone Number | (707) 442-6325 | ||
| Country | United States |
| Full Name | Erwin Shields | ||
| Gender | male | ||
| Birthday | 1982-02-10 | ||
| Social Security Number | 504-45-9459 |
| Credit card brand | EnRoute | ||
| Credit card number | 2149393375895254 | ||
| Expire | 2030/7 | ||
| CVV | 047 |