| Date of birth: | 1975 |
| Hair: | Bald |
| Eyes: | Hazel |
| State id: | 1053683 |
| SO#: | 281013 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0413543 |
| Booking date: | Jun 3, 2004 |
| Release date: | Jun 3, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |