| Date of birth: | 1942 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 244136 |
| SO#: | 133095 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Booking number: | 9320242 |
| Booking date: | Nov 16, 1993 |
| Release date: | Nov 17, 1993 |
| Booking location: | Salt Lake County, UT |
| Number: | 925011223 |
| Amount: | $330 |