| Date of birth: | 1936 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 355376 |
| SO#: | 176485 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Booking number: | 9410974 |
| Booking date: | Jun 17, 1994 |
| Release date: | Jun 26, 1994 |
| Booking location: | Salt Lake County, UT |
| Number: | 912011551 |
| Amount: | $1,000 |