| Date of birth: | 1925 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 380528 |
| SO#: | 186650 |
| Booked at: | SALT LAKE |
| Cob: | Missouri |
| Booking number: | 9414979 |
| Booking date: | Aug 14, 1994 |
| Release date: | Aug 17, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $300 |
| Number: | 935003312 |
| Amount: | $255 |
| Number: | 94745 |