| Date of birth: | 1925 |
| Hair: | Brown |
| Eyes: | Blue |
| SO#: | 127457 |
| Booked at: | SALT LAKE |
| Cob: | Indiana |
| Booking number: | 9321369 |
| Booking date: | Dec 6, 1993 |
| Release date: | Dec 6, 1993 |
| Booking location: | Salt Lake County, UT |
| Number: | 921013244 |
| Amount: | $505 |
| Number: | NA |
| Amount: | $110 |