| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 237307 |
| SO#: | 132834 |
| Booked at: | SALT LAKE |
| Cob: | Nevada |
| Booking number: | 9829363 |
| Booking date: | Dec 19, 1998 |
| Release date: | Dec 19, 1998 |
| Booking location: | Salt Lake County, UT |
| Number: | 971001645 |
| Amount: | $1,500 |