| Date of birth: | 1930 |
| Hair: | White |
| Eyes: | Blue |
| State id: | 301140 |
| SO#: | 199961 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9423030 |
| Booking date: | Dec 7, 1994 |
| Release date: | Dec 7, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 941019324FS |
| Amount: | $3,500 |