| Date of birth: | 1962 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 371747 |
| SO#: | 183531 |
| Booked at: | SALT LAKE |
| Cob: | Nevada |
| Citizen: | UNITED STATES |
| Booking number: | 0401595 |
| Booking date: | Jan 20, 2004 |
| Release date: | Jan 29, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 031901967 |
| Number: | 98-4124 |
| Amount: | $200 |
