| Date of birth: | 1938 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 500014 |
| SO#: | 220128 |
| Booked at: | SALT LAKE |
| Cob: | West Virginia |
| Booking number: | 9712102 |
| Booking date: | May 29, 1997 |
| Release date: | May 29, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $500 |