| Date of birth: | 1939 |
| Hair: | Brown |
| Eyes: | Brown |
| SO#: | 193486 |
| Booked at: | SALT LAKE |
| Cob: | Michigan |
| Booking number: | 9401522 |
| Booking date: | Jan 23, 1994 |
| Release date: | Jan 31, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $150 |
| Number: | 931009278 |
| Amount: | $505 |