| Street | 101 Main St | ||
| City/Town | Washburn | ||
| State/Province/Region | North Dakota | ||
| Zip/Postal Code | 58577 | ||
| Phone Number | (701) 462-8111 | ||
| Country | United States |
| Full Name | Clement Kiehn | ||
| Gender | male | ||
| Birthday | 1994-08-21 | ||
| Social Security Number | 463-99-3903 |
| Credit card brand | Diners Club | ||
| Credit card number | 3000716075523519 | ||
| Expire | 2029/11 | ||
| CVV | 451 |