| Date of birth: | 1957 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 0367682 |
| SO#: | 172611 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9607692 |
| Booking date: | Apr 9, 1996 |
| Release date: | Apr 9, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 4964000893 |
| Amount: | $1,500 |