| Date of birth: | 1932 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 925888 |
| SO#: | 91930 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9421669 |
| Booking date: | Nov 17, 1994 |
| Release date: | Nov 17, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 3-943005103 |