| Date of birth: | 1927 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 302792 |
| SO#: | 159836 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Booking number: | 9923534 |
| Booking date: | Sep 22, 1999 |
| Release date: | Sep 28, 1999 |
| Booking location: | Salt Lake County, UT |
| Number: | 991400717 |
| Amount: | $1,500 |
| Number: | 992201 |