| Church/Organization | |
| Preferred First Name | |
| Street Address | 4065 Berkeley View Dr |
| City | Berkeley Lake |
| Postal/Zip Code | 30096 |
| Website | |
| Home Phone |
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 23 years, 8 months ago |
