| Date of birth: | 1957 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 660057 |
| SO#: | 283318 |
| Booked at: | SALT LAKE |
| Cob: | Illinois |
| Citizen: | UNITED STATES |
| Booking number: | 0422418 |
| Booking date: | Sep 18, 2004 |
| Release date: | Sep 18, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,567 |