| Date of birth: | 1945 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 479162 |
| SO#: | 226489 |
| Booked at: | SALT LAKE |
| Cob: | Kansas |
| Booking number: | 0122637 |
| Booking date: | Sep 13, 2001 |
| Release date: | Sep 18, 2001 |
| Booking location: | Salt Lake County, UT |
| Amount: | $555 |
| Number: | 011913519 |
| Amount: | $2,500 |
| Number: | 29885 |