| Date of birth: | 1944 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 0399605 |
| SO#: | 190501 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9701104 |
| Booking date: | Jan 14, 1997 |
| Release date: | Jan 14, 1997 |
| Booking location: | Salt Lake County, UT |
| Number: | 961025315FS |
| Amount: | $2,500 |