| Date of birth: | 1945 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 396772 |
| SO#: | 193005 |
| Booked at: | SALT LAKE |
| Cob: | Pennsylvania |
| Booking number: | 9601598 |
| Booking date: | Jan 20, 1996 |
| Release date: | Jan 23, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 941700397 |
| Amount: | $5,000 |