| Date of birth: | 1954 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 289833 |
| SO#: | 159472 |
| Booked at: | SALT LAKE |
| Cob: | Ohio |
| Booking number: | 9620188 |
| Booking date: | Oct 15, 1996 |
| Release date: | Oct 15, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 911006283 |
| Amount: | $2,500 |