| Date of birth: | 1924 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 503547 |
| SO#: | 224005 |
| Booked at: | SALT LAKE |
| Cob: | Virginia |
| Booking number: | 9724855 |
| Booking date: | Nov 3, 1997 |
| Release date: | Nov 6, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $2,575 |