| Date of birth: | 1939 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 110671 |
| SO#: | 55154 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9706004 |
| Booking date: | Mar 14, 1997 |
| Release date: | Mar 17, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $450 |
| Number: | 941700755 |