| Date of birth: | 1927 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 400250 |
| SO#: | 233317 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9828477 |
| Booking date: | Dec 9, 1998 |
| Release date: | Dec 9, 1998 |
| Booking location: | Salt Lake County, UT |
| Number: | 984006526 |