| Date of birth: | 1952 |
| Hair: | Brown |
| Eyes: | Green |
| State id: | 457699 |
| SO#: | 206596 |
| Booked at: | SALT LAKE |
| Cob: | Nevada |
| Booking number: | 9716472 |
| Booking date: | Jul 21, 1997 |
| Release date: | Jul 21, 1997 |
| Booking location: | Salt Lake County, UT |
| Number: | 951012004 |
| Amount: | $250 |