| Date of birth: | 1936 |
| Hair: | Gray or partially gray |
| Eyes: | Green |
| State id: | 0378609 |
| SO#: | 187438 |
| Booked at: | SALT LAKE |
| Cob: | South Dakota |
| Booking number: | 9612240 |
| Booking date: | Jul 7, 1996 |
| Release date: | Jul 7, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | NA |
| Amount: | $1,560 |
