| Date of birth: | 1941 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 635800 |
| SO#: | 263435 |
| Booked at: | SALT LAKE |
| Cob: | Virginia |
| Citizen: | UNITED STATES |
| Booking number: | 0211421 |
| Booking date: | May 22, 2002 |
| Release date: | May 23, 2002 |
| Booking location: | Salt Lake County, UT |
| Amount: | $280 |