| Date of birth: | 1945 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 419506 |
| SO#: | 200644 |
| Booked at: | SALT LAKE |
| Cob: | Nevada |
| Booking number: | 9510304 |
| Booking date: | May 11, 1995 |
| Release date: | May 19, 1995 |
| Booking location: | Salt Lake County, UT |
| Amount: | $150 |
| Number: | 95-00110 |
| Amount: | $1,680 |