| Church/Organization | |
| Preferred First Name | |
| Street Address | 345 Janice Way |
| City | Merlin |
| Postal/Zip Code | 97532 |
| Home Phone | |
| Office Phone |
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 51 years, 11 months ago |
| Place of Chaplaincy | Marketplace |
