| Date of birth: | 1947 |
| Hair: | Black |
| Eyes: | Brown |
| SO#: | 267017 |
| Booked at: | SALT LAKE |
| Booking number: | 0330525 |
| Booking date: | Dec 7, 2003 |
| Release date: | Dec 7, 2003 |
| Booking location: | Salt Lake County, UT |
| Number: | 005106411 |
| Amount: | $150 |
| Number: | 03-02896 |
| Amount: | $2,170 |