| Church/Organization | |
| Preferred First Name | |
| Street Address | 109 Mound St |
| City | Shakopee |
| Postal/Zip Code | 55379 |
| Mobile Phone | |
| Home Phone | |
| Office Phone |
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 61 years, 9 months ago |
