| Date of birth: | 1955 |
| Hair: | Black |
| Eyes: | Blue |
| State id: | 175701 |
| SO#: | 100334 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0523917 |
| Booking date: | Oct 3, 2005 |
| Release date: | Oct 4, 2005 |
| Booking location: | Salt Lake County, UT |
| Amount: | $925 |