| Date of birth: | 1930 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 350467 |
| SO#: | 43741 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9407783 |
| Booking date: | Apr 30, 1994 |
| Release date: | May 3, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $350 |
| Number: | 912013485 |
| Amount: | $505 |