| Date of birth: | 1944 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 268104 |
| SO#: | 147620 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Citizen: | UNITED STATES |
| Booking number: | 0507244 |
| Booking date: | Mar 26, 2005 |
| Release date: | Mar 26, 2005 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,500 |