| Date of birth: | 1947 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 501394 |
| SO#: | 72279 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0423104 |
| Booking date: | Sep 27, 2004 |
| Release date: | May 10, 2005 |
| Booking location: | Salt Lake County, UT |
| Number: | 011913473 |