| Date of birth: | 1915 |
| Hair: | Gray or partially gray |
| Eyes: | Hazel |
| State id: | 470298 |
| SO#: | 219186 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Booking number: | 9708822 |
| Booking date: | Apr 17, 1997 |
| Release date: | Apr 17, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $300 |