| Date of birth: | 1941 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 507779 |
| SO#: | 228706 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Citizen: | UNITED STATES |
| Booking number: | 0419378 |
| Booking date: | Aug 13, 2004 |
| Release date: | Aug 17, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 041101812 |
| Amount: | $50,000 |