| Date of birth: | 1936 |
| Hair: | Gray or partially gray |
| Eyes: | Hazel |
| State id: | 097254 |
| SO#: | 45530 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0407338 |
| Booking date: | Mar 23, 2004 |
| Release date: | Dec 10, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 031904437 |
| Amount: | $50,000 |