| Date of birth: | 1939 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 262618 |
| SO#: | 144389 |
| Booked at: | SALT LAKE |
| Cob: | Missouri |
| Booking number: | 9320200 |
| Booking date: | Nov 16, 1993 |
| Release date: | Nov 17, 1993 |
| Booking location: | Salt Lake County, UT |
| Amount: | $100 |
| Number: | 860029166FS |
| Amount: | $2,500 |