| Date of birth: | 1944 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 202596 |
| SO#: | 206950 |
| Booked at: | SALT LAKE |
| Cob: | North Dakota |
| Booking number: | 9521558 |
| Booking date: | Oct 10, 1995 |
| Release date: | Oct 11, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 941004035 |
| Amount: | $1,140 |