| Date of birth: | 1947 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 383219 |
| SO#: | 187962 |
| Booked at: | SALT LAKE |
| Cob: | Michigan |
| Booking number: | 9701701 |
| Booking date: | Jan 22, 1997 |
| Release date: | Jan 25, 1997 |
| Booking location: | Salt Lake County, UT |
| Number: | 2-932000473 |
| Amount: | $300 |
| Number: | 941900548 |