| Date of birth: | 1920 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 650122 |
| SO#: | 268087 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0228382 |
| Booking date: | Dec 10, 2002 |
| Release date: | Dec 10, 2002 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,850 |