| Date of birth: | 1947 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 230739 |
| SO#: | 129855 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9510970 |
| Booking date: | May 20, 1995 |
| Release date: | Aug 24, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 933000797 |
| Amount: | $1,005 |