| Date of birth: | 1939 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 00178700 |
| SO#: | 105187 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0305155 |
| Booking date: | Feb 24, 2003 |
| Release date: | Feb 24, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,634 |