| Date of birth: | 1932 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 0121915 |
| SO#: | 205894 |
| Booked at: | SALT LAKE |
| Cob: | Florida |
| Booking number: | 9518416 |
| Booking date: | Aug 30, 1995 |
| Release date: | Sep 9, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 941017559 |
| Amount: | $5,000 |