| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 323484 |
| SO#: | 168927 |
| Booked at: | SALT LAKE |
| Cob: | South Dakota |
| Citizen: | UNITED STATES |
| Booking number: | 0208614 |
| Booking date: | Apr 19, 2002 |
| Release date: | Apr 19, 2002 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |