|
| First
Name |
John |
| Last Name |
Doe |
| Address |
5000
Forbes Avenue |
| City |
Pittsburgh |
| State |
PA |
| Zip Code |
15230 |
| Country |
USA |
| Phone Number |
(412)555-5555 |
| Email |
johndoe@cmu.edu |
|
| Name On Card |
John
Doe |
| Card Type |
Visa |
| Card Number |
5555-5555-5555-5555 |
| Expiration |
January
2005 |
| |
|
|