| Date of birth: | 1937 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| SO#: | 278755 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0404895 |
| Booking date: | Feb 26, 2004 |
| Release date: | Feb 26, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 041100370FS |
| Amount: | $10,000 |