| Date of birth: | 1943 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 178515 |
| SO#: | 105086 |
| Booked at: | SALT LAKE |
| Cob: | Idaho |
| Booking number: | 9510703 |
| Booking date: | May 16, 1995 |
| Release date: | May 19, 1995 |
| Booking location: | Salt Lake County, UT |
| Number: | 942000347 |
| Amount: | $470 |