| Date of birth: | 1918 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| SO#: | 199087 |
| Booked at: | SALT LAKE |
| Cob: | Oklahoma |
| Booking number: | 9420228 |
| Booking date: | Oct 27, 1994 |
| Release date: | Oct 28, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 941008016 |
| Amount: | $500 |