| Date of birth: | 1937 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 151568 |
| SO#: | 83479 |
| Booked at: | SALT LAKE |
| Cob: | South Dakota |
| Citizen: | UNITED STATES |
| Booking number: | 0221080 |
| Booking date: | Sep 18, 2002 |
| Release date: | Sep 24, 2002 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |
| Number: | 011909345 |
| Amount: | $2,500 |
| Number: | 011915015 |
| Amount: | $145 |
