| Date of birth: | 1934 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 579725 |
| SO#: | 240946 |
| Booked at: | SALT LAKE |
| Cob: | Tennessee |
| Booking number: | 9927330 |
| Booking date: | Nov 5, 1999 |
| Release date: | Nov 6, 1999 |
| Booking location: | Salt Lake County, UT |
| Number: | 991100843 |
| Amount: | $1,000 |