| Date of birth: | 1919 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| SO#: | 207511 |
| Booked at: | SALT LAKE |
| Booking number: | 9525509 |
| Booking date: | Dec 5, 1995 |
| Release date: | Jan 10, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $200 |
| Number: | 951022689 |
| Amount: | $505 |