| Date of birth: | 1954 |
| Hair: | Blonde |
| Eyes: | Green |
| State id: | 634858 |
| SO#: | 280497 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Citizen: | UNITED STATES |
| Booking number: | 0411688 |
| Booking date: | May 11, 2004 |
| Release date: | May 12, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |