| Date of birth: | 1944 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 444106 |
| SO#: | 212804 |
| Booked at: | SALT LAKE |
| Cob: | Wyoming |
| Citizen: | UNITED STATES |
| Booking number: | 0332009 |
| Booking date: | Dec 27, 2003 |
| Release date: | Dec 29, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $10,000 |