| Date of birth: | 1917 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 092646 |
| SO#: | 40328 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9608683 |
| Booking date: | Apr 25, 1996 |
| Release date: | Apr 26, 1996 |
| Booking location: | Salt Lake County, UT |
| Number: | 961008369 |
| Amount: | $10,000 |