Trusted Form

Lead Verification Details

Securely captured and verified lead information

This lead has been verified and consent recorded.

Contact Information

First Name

Karen Stucker

Last Name

Elam

ZIP Code

33709

State

FL

Date of Birth

1950-06-13

Verification Log

TokenFE-MVJVWRFX-OG4L1X
Submitted10/22/2026, 6:38:36 PM
IP Address58.65.217.146
Time on Form724s
Consent✓ Recorded