| Date of birth: | 1933 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 407057 |
| SO#: | 196164 |
| Booked at: | SALT LAKE |
| Cob: | Kentucky |
| Citizen: | UNITED STATES |
| Booking number: | 0228215 |
| Booking date: | Dec 8, 2002 |
| Release date: | Dec 8, 2002 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,500 |