| Date of birth: | 1942 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 396723 |
| SO#: | 203282 |
| Booked at: | SALT LAKE |
| Booking number: | 9509563 |
| Booking date: | May 2, 1995 |
| Release date: | May 11, 1995 |
| Booking location: | Salt Lake County, UT |
| Amount: | $450 |
| Number: | 931016430 |
| Amount: | $1,500 |