| Date of birth: | 1963 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 432395 |
| SO#: | 284329 |
| Booked at: | SALT LAKE |
| Cob: | California |
| Citizen: | UNITED STATES |
| Booking number: | 0426216 |
| Booking date: | Nov 5, 2004 |
| Release date: | Nov 10, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $555 |
| Number: | 031404464 |