| Date of birth: | 1964 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 1252048 |
| SO#: | 349961 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 11049017 |
| Booking date: | Sep 26, 2011 |
| Release date: | Sep 29, 2011 |
| Booking location: | Salt Lake County, UT |
| Offense date: | Sep 26, 2011 |
| Grade: | F |
| Description: | Forgery (specify documents) |
| Degree: | 3 |
| Code: | 76.6.501 |
| Status: | Open |
| Posted: | Sep 27, 2011 |
| Amount: | $5,000 |