| Date of birth: | 1947 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 276375 |
| SO#: | 150472 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9701350 |
| Booking date: | Jan 17, 1997 |
| Release date: | Jan 25, 1997 |
| Booking location: | Salt Lake County, UT |
| Number: | 955028701 |
| Amount: | $327 |