| Church/Organization | |
| Preferred First Name | |
| Street Address | 18792 Dunbury Avenue |
| City | Farmington |
| Postal/Zip Code | 55024 |
| Mobile Phone | |
| Website | |
| Home Phone |
| Membership Credential | |
| Marital Status | Remarried |
| Length of Marriage | 7 years, 10 months ago |
