| Date of birth: | 1954 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 282780 |
| SO#: | 185468 |
| Booked at: | SALT LAKE |
| Cob: | New Mexico |
| Citizen: | UNITED STATES |
| Booking number: | 0320155 |
| Booking date: | Aug 9, 2003 |
| Release date: | Aug 9, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |