| Date of birth: | 1938 |
| Hair: | Brown |
| Eyes: | Blue |
| SO#: | 207887 |
| Booked at: | SALT LAKE |
| Cob: | Michigan |
| Booking number: | 9524815 |
| Booking date: | Nov 25, 1995 |
| Release date: | Nov 26, 1995 |
| Booking location: | Salt Lake County, UT |
| Amount: | $150 |
| Number: | 951017427 |
| Amount: | $505 |