| Date of birth: | 1952 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 467159 |
| SO#: | 217824 |
| Booked at: | SALT LAKE |
| Cob: | Tennessee |
| Citizen: | UNITED STATES |
| Booking number: | 0324054 |
| Booking date: | Sep 23, 2003 |
| Release date: | Sep 23, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,850 |