| Date of birth: | 1955 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 1062565 |
| SO#: | 284402 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Citizen: | UNITED STATES |
| Booking number: | 0426457 |
| Booking date: | Nov 7, 2004 |
| Release date: | Nov 10, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $8,885 |