| Date of birth: | 1935 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 251061 |
| SO#: | 139313 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Booking number: | 9507478 |
| Booking date: | Apr 6, 1995 |
| Release date: | Apr 6, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 921009158 |
| Amount: | $505 |