| Date of birth: | 1944 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 185155 |
| SO#: | 109029 |
| Booked at: | SALT LAKE |
| Cob: | Colorado |
| Booking number: | 9507123 |
| Booking date: | Apr 1, 1995 |
| Release date: | Apr 3, 1995 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,150 |
| Number: | 925007612 |
| Amount: | $185 |