| Date of birth: | 1926 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 925388 |
| SO#: | 194927 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9406673 |
| Booking date: | Apr 14, 1994 |
| Release date: | Apr 15, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 925000094 |
| Amount: | $145 |