| Date of birth: | 1923 |
| Hair: | Brown |
| Eyes: | Blue |
| SO#: | 209328 |
| Booked at: | SALT LAKE |
| Cob: | Washington |
| Booking number: | 9602202 |
| Booking date: | Jan 28, 1996 |
| Release date: | Feb 1, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $600 |
| Number: | 941020792 |
| Amount: | $3,000 |