| Church/Organization | |
| Preferred First Name | |
| Street Address | 1025 Thimblegate Ct |
| City | Alpharetta |
| Postal/Zip Code | 30022 |
| Home Phone | |
| Office Phone |
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 15 years, 8 months ago |
