| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 142049 |
| SO#: | 77996 |
| Booked at: | SALT LAKE |
| Cob: | New Mexico |
| Booking number: | 9420588 |
| Booking date: | Nov 1, 1994 |
| Release date: | Nov 15, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $150 |
| Number: | 941000294 |
| Amount: | $1,000 |