[Getiandre]

1. Name
2. Street address
3. City
4. State
5. Zip code
6. Date of birth
7. Sex (M/F)
8. Race (White/Black/Asian/Other)
9. Marital status (Single/Married/Divorced/Widowed)
10. Occupation
11. Employer
12. Social Security Number
13. Driver License Number
14. Vehicle Identification Number