| Date of birth: | 1950 |
| Hair: | Brown |
| Eyes: | Blue |
| SO#: | 360195 |
| Booked at: | SALT LAKE |
| Cob: | New York |
| Citizen: | UNITED STATES |
| Booking number: | 12049205 |
| Booking date: | Sep 20, 2012 |
| Release date: | Sep 20, 2012 |
| Booking location: | Salt Lake County, UT |
| Offense date: | Sep 20, 2012 |
| Grade: | M |
| Description: | Controlled Substances-Possession prohibited |
| Degree: | B |
| Code: | 11.24.020 |
| Case number: | 121601117 |
| Number: | 121601117 |