| Date of birth: | 1936 |
| Hair: | Brown |
| Eyes: | Blue |
| State id: | 178277 |
| SO#: | 187217 |
| Booked at: | SALT LAKE |
| Cob: | Nebraska |
| Booking number: | 9724899 |
| Booking date: | Nov 3, 1997 |
| Release date: | Nov 3, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $150 |
| Number: | 5-965001968 |
| Amount: | $255 |