| Date of birth: | 1941 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| SO#: | 238118 |
| Booked at: | SALT LAKE |
| Cob: | West Virginia |
| Booking number: | 9916518 |
| Booking date: | Jul 7, 1999 |
| Release date: | Jul 7, 1999 |
| Booking location: | Salt Lake County, UT |
| Number: | 995005153 |
| Amount: | $170 |