| Date of birth: | 1946 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 123911 |
| SO#: | 64860 |
| Booked at: | SALT LAKE |
| Cob: | Wisconsin |
| Citizen: | UNITED STATES |
| Booking number: | 0911459 |
| Booking date: | Apr 21, 2009 |
| Release date: | Apr 21, 2009 |
| Booking location: | Salt Lake County, UT |
| Number: | 005306513 |
| Number: | 03CR13693 |
| Amount: | $1,295 |