| Date of birth: | 1953 |
| Hair: | Red or auburn |
| Eyes: | Blue |
| State id: | 374197 |
| SO#: | 183984 |
| Booked at: | SALT LAKE |
| Cob: | Kansas |
| Citizen: | UNITED STATES |
| Booking number: | 0417559 |
| Booking date: | Jul 22, 2004 |
| Release date: | Jul 27, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,110 |