| Date of birth: | 1952 |
| Hair: | Black |
| Eyes: | Green |
| State id: | 148975 |
| SO#: | 82644 |
| Booked at: | SALT LAKE |
| Cob: | North Carolina |
| Citizen: | UNITED STATES |
| Booking number: | 0912569 |
| Booking date: | May 2, 2009 |
| Release date: | May 2, 2009 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |