| Date of birth: | 1955 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 0352916 |
| SO#: | 175475 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Booking number: | 9611336 |
| Booking date: | Jun 19, 1996 |
| Release date: | Jun 20, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 911001083 |
| Amount: | $1,500 |