| Date of birth: | 1960 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 268089 |
| SO#: | 148379 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0409031 |
| Booking date: | Apr 10, 2004 |
| Release date: | Apr 10, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,279 |