| Date of birth: | 1926 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 579621 |
| SO#: | 240844 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9926893 |
| Booking date: | Oct 31, 1999 |
| Release date: | Oct 31, 1999 |
| Booking location: | Salt Lake County, UT |
| Number: | 991919575 |
| Amount: | $2,500 |