| Date of birth: | 1948 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 366664 |
| SO#: | 160506 |
| Booked at: | SALT LAKE |
| Cob: | Illinois |
| Booking number: | 9624002 |
| Booking date: | Dec 1, 1996 |
| Release date: | Dec 1, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 921005033 |
| Amount: | $2,000 |