| Date of birth: | 1942 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 1087002 |
| SO#: | 293617 |
| Booked at: | SALT LAKE |
| Cob: | Pennsylvania |
| Citizen: | UNITED STATES |
| Booking number: | 0627104 |
| Booking date: | Oct 14, 2006 |
| Release date: | Oct 14, 2006 |
| Booking location: | Salt Lake County, UT |
| Amount: | $480 |