| Date of birth: | 1930 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 229410 |
| SO#: | 139550 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9500347 |
| Booking date: | Jan 6, 1995 |
| Release date: | Jan 8, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 921009455 |
| Amount: | $2,500 |