| Date of birth: | 1943 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 286801 |
| SO#: | 154488 |
| Booked at: | SALT LAKE |
| Cob: | Kansas |
| Booking number: | 9503527 |
| Booking date: | Feb 15, 1995 |
| Release date: | Feb 17, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 20318880952 |
| Amount: | $505 |
| Number: | CR87-1616 |