| Date of birth: | 1969 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 416923 |
| SO#: | 283039 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0421296 |
| Booking date: | Sep 4, 2004 |
| Release date: | Sep 7, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 011400094 |
| Number: | 96 433 |
| Amount: | $610 |