| Date of birth: | 1942 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 146790 |
| SO#: | 81115 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9612570 |
| Booking date: | Jul 14, 1996 |
| Release date: | Jul 14, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 961002838MS |
| Number: | 964001613 |
| Amount: | $300 |