| First Name | |
| Preferred First Name | |
| Last Name | |
| Street Address | 241 Vista Creek Cir |
| City | Sacramento |
| Postal/Zip Code | 95835 |
| Mobile Phone | |
| Home Phone |
| Membership Credential | |
| Mailing List | Yes |
| Marital Status | Married |
| Length of Marriage | 47 years, 8 months ago |
