| Date of birth: | 1926 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 141565 |
| SO#: | 77635 |
| Booked at: | SALT LAKE |
| Cob: | Colorado |
| Booking number: | 9411179 |
| Booking date: | Jun 19, 1994 |
| Release date: | Jun 20, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 935005657 |
| Amount: | $460 |