| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 301327 |
| SO#: | 157544 |
| Booked at: | SALT LAKE |
| Cob: | Missouri |
| Booking number: | 9513615 |
| Booking date: | Jun 25, 1995 |
| Release date: | Jun 26, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 945002129 |
| Amount: | $880 |