| Date of birth: | 1925 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 516146 |
| SO#: | 238273 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9917198 |
| Booking date: | Jul 14, 1999 |
| Release date: | Jul 14, 1999 |
| Booking location: | Salt Lake County, UT |
| Number: | 991905602 |
| Amount: | $25,000 |