| Date of birth: | 1938 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 302703 |
| SO#: | 159615 |
| Booked at: | SALT LAKE |
| Cob: | Florida |
| Booking number: | 9606921 |
| Booking date: | Mar 29, 1996 |
| Release date: | Apr 2, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 95-664 |
| Number: | W876280706 |