| Date of birth: | 1947 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 0506712 |
| SO#: | 227516 |
| Booked at: | SALT LAKE |
| Cob: | Colorado |
| Citizen: | UNITED STATES |
| Booking number: | 0228178 |
| Booking date: | Dec 8, 2002 |
| Release date: | Dec 8, 2002 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |