| Date of birth: | 1950 |
| Hair: | Brown |
| Eyes: | Green |
| State id: | 259940 |
| SO#: | 142992 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0331717 |
| Booking date: | Dec 22, 2003 |
| Release date: | Jan 16, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 0227838 |
| Amount: | $370 |