| Date of birth: | 1942 |
| Hair: | Blonde |
| Eyes: | Blue |
| State id: | 658319 |
| SO#: | 140108 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Citizen: | UNITED STATES |
| Booking number: | 0416920 |
| Booking date: | Jul 15, 2004 |
| Release date: | Jul 15, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 04CR04638 |
| Amount: | $2,500 |