| Date of birth: | 1937 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 155859 |
| SO#: | 88543 |
| Booked at: | SALT LAKE |
| Cob: | Oklahoma |
| Booking number: | 9623892 |
| Booking date: | Nov 30, 1996 |
| Release date: | Nov 30, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $100 |
| Number: | 951013571 |
| Amount: | $2,500 |