| Date of birth: | 1936 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 0389316 |
| SO#: | 213997 |
| Booked at: | SALT LAKE |
| Cob: | Wyoming |
| Booking number: | 9617559 |
| Booking date: | Sep 13, 1996 |
| Release date: | Sep 18, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 931010063 |
| Amount: | $505 |
| Number: | 931013131 |
| Amount: | $150 |
| Number: | D656/174 |
| Amount: | $120 |
