| Date of birth: | 1921 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 267154 |
| SO#: | 230120 |
| Booked at: | SALT LAKE |
| Cob: | Texas |
| Booking number: | 9816975 |
| Booking date: | Jul 25, 1998 |
| Release date: | Jul 25, 1998 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,390 |