| Date of birth: | 1920 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| SO#: | 205705 |
| Booked at: | SALT LAKE |
| Cob: | Illinois |
| Booking number: | 9517851 |
| Booking date: | Aug 24, 1995 |
| Release date: | Aug 28, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 931007796 |
| Amount: | $500 |