| Date of birth: | 1953 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 367199 |
| SO#: | 175963 |
| Booked at: | SALT LAKE |
| Cob: | Kansas |
| Booking number: | 9417656 |
| Booking date: | Sep 19, 1994 |
| Release date: | Oct 6, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 941015976FS |
| Amount: | $5,000 |