| Church/Organization | |
| Preferred First Name | |
| Street Address | 7488 Cleadis Way East |
| City | Inver Grove Heights |
| Postal/Zip Code | 55076 |
| Website | |
| Home Phone |
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Remarried |
| Length of Marriage | 39 years ago |
