| Date of birth: | 1947 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 1009855 |
| SO#: | 293029 |
| Booked at: | SALT LAKE |
| Cob: | Missouri |
| Citizen: | UNITED STATES |
| Booking number: | 0528454 |
| Booking date: | Nov 19, 2005 |
| Release date: | Nov 23, 2005 |
| Booking location: | Salt Lake County, UT |
| Amount: | $16,877 |
| Number: | 2004 2137 |
| Amount: | $150 |