| Date of birth: | 1933 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 121915 |
| SO#: | 73265 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9508022 |
| Booking date: | Apr 12, 1995 |
| Release date: | Apr 15, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 944003344MC |
| Amount: | $2,005 |