| Date of birth: | 1954 |
| Hair: | Brown |
| Eyes: | Brown |
| SO#: | 282512 |
| Booked at: | SALT LAKE |
| Cob: | Pennsylvania |
| Citizen: | UNITED STATES |
| Booking number: | 0419217 |
| Booking date: | Aug 12, 2004 |
| Release date: | Aug 24, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 041905221 |