| Date of birth: | 1933 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 383829 |
| SO#: | 202060 |
| Booked at: | SALT LAKE |
| Cob: | Colorado |
| Booking number: | 9610524 |
| Booking date: | Jun 3, 1996 |
| Release date: | Jun 3, 1996 |
| Booking location: | Salt Lake County, UT |
| Amount: | $550 |
| Number: | 951001207 |
| Amount: | $1,000 |