| Date of birth: | 1954 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 211124 |
| SO#: | 74450 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0927859 |
| Booking date: | Oct 2, 2009 |
| Release date: | Oct 3, 2009 |
| Booking location: | Salt Lake County, UT |
| Amount: | $5,200 |