| Date of birth: | 1942 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 903461 |
| SO#: | 36515 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0900341 |
| Booking date: | Jan 4, 2009 |
| Release date: | Jan 4, 2009 |
| Booking location: | Salt Lake County, UT |
| Number: | 031907504 |
| Amount: | $5,000 |