| Date of birth: | 1962 |
| Hair: | Black |
| Eyes: | Brown |
| SO#: | 281270 |
| Booked at: | SALT LAKE |
| Cob: | Ohio |
| Citizen: | UNITED STATES |
| Booking number: | 0414587 |
| Booking date: | Jun 16, 2004 |
| Release date: | Jun 19, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $555 |
| Number: | 04CR07743 |