| Date of birth: | 1960 |
| Hair: | Blonde |
| Eyes: | Blue |
| State id: | 476764 |
| SO#: | 281454 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0415243 |
| Booking date: | Jun 24, 2004 |
| Release date: | Nov 11, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 03-6573 |
| Amount: | $300 |