| Date of birth: | 1948 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 353990 |
| SO#: | 175981 |
| Booked at: | SALT LAKE |
| Cob: | Texas |
| Citizen: | UNITED STATES |
| Booking number: | 0624774 |
| Booking date: | Sep 20, 2006 |
| Release date: | Sep 20, 2006 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |
| Number: | 03CR10973 |
| Amount: | $100 |