| Date of birth: | 1963 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 323353 |
| SO#: | 217419 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0417906 |
| Booking date: | Jul 28, 2004 |
| Release date: | Aug 3, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 25275 |
| Number: | C03-05995 |
| Amount: | $5,005 |