| Date of birth: | 1920 |
| Hair: | Gray or partially gray |
| Eyes: | Blue |
| State id: | 500934 |
| SO#: | 221203 |
| Booked at: | SALT LAKE |
| Cob: | Kentucky |
| Booking number: | 9715755 |
| Booking date: | Jul 13, 1997 |
| Release date: | Jul 13, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $100 |