| Date of birth: | Apr 30, 1936 |
| Hair length: | SHORT HAIR |
| State id: | 063-26-96-0 |
| Permanent id: | 03-00107 |
| Complexion: | FAIR SKINNED |
| Cob: | USA |
| Citizen: | USA |
| Booking number: | 03-00206 |
| Booking date: | Apr 1, 2003 |
| Release date: | Apr 3, 2003 |
| Booking location: | Mifflin County, PA |