| Date of birth: | 1936 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 091870 |
| SO#: | 42412 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0520861 |
| Booking date: | Aug 29, 2005 |
| Release date: | Nov 2, 2005 |
| Booking location: | Salt Lake County, UT |
| Number: | 051905370 |
| Amount: | $5,000 |