| Date of birth: | 1942 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 320827 |
| SO#: | 158104 |
| Booked at: | SALT LAKE |
| Cob: | West Virginia |
| Booking number: | 9401185 |
| Booking date: | Jan 18, 1994 |
| Release date: | Apr 4, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 912032998 |
| Amount: | $3,000 |