| Date of birth: | 1943 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 312932 |
| SO#: | 146685 |
| Booked at: | SALT LAKE |
| Cob: | Texas |
| Booking number: | 9502125 |
| Booking date: | Jan 28, 1995 |
| Release date: | Feb 8, 1995 |
| Booking location: | Salt Lake County, UT |
| Amount: | $300 |
| Number: | 941002079 |
| Amount: | $50 |