| Date of birth: | 1929 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 212640 |
| SO#: | 121640 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9801267 |
| Booking date: | Jan 16, 1998 |
| Release date: | Jan 16, 1998 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,614 |