| Date of birth: | 1925 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 211725 |
| SO#: | 121953 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9501374 |
| Booking date: | Jan 19, 1995 |
| Release date: | Jan 19, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 941017981FS |
| Amount: | $10,000 |