| Date of birth: | 1912 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 131176 |
| SO#: | 70531 |
| Booked at: | SALT LAKE |
| Cob: | Texas |
| Booking number: | 9406239 |
| Booking date: | Apr 7, 1994 |
| Release date: | Apr 7, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 2-2288-192BC |
| Amount: | $1,470 |