| Date of birth: | 1934 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 136398 |
| SO#: | 74149 |
| Booked at: | SALT LAKE |
| Cob: | Nevada |
| Booking number: | 9715972 |
| Booking date: | Jul 16, 1997 |
| Release date: | Jul 16, 1997 |
| Booking location: | Salt Lake County, UT |
| Number: | 971-1220 |