| Date of birth: | 1950 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 505578 |
| SO#: | 226249 |
| Booked at: | SALT LAKE |
| Cob: | Oklahoma |
| Citizen: | UNITED STATES |
| Booking number: | 411567 |
| Booking date: | May 10, 2004 |
| Release date: | Jun 9, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 041901896 |
| Amount: | $10,000 |