| Date of birth: | 1940 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 138533 |
| SO#: | 75654 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9523022 |
| Booking date: | Oct 30, 1995 |
| Release date: | Jan 4, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $500 |
| Number: | 951013423MC |
| Amount: | $2,500 |