| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Hazel |
| State id: | 124593 |
| SO#: | 65603 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9603891 |
| Booking date: | Feb 18, 1996 |
| Release date: | Feb 25, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $50 |
| Number: | 941008014 |
| Amount: | $500 |