| Date of birth: | 1964 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 0484910 |
| SO#: | 210071 |
| Booked at: | SALT LAKE |
| Cob: | Pennsylvania |
| Citizen: | UNITED STATES |
| Booking number: | 0415354 |
| Booking date: | Jun 25, 2004 |
| Release date: | Feb 3, 2005 |
| Booking location: | Salt Lake County, UT |
| Number: | 031800141 |
| Amount: | $3,000 |