| Date of birth: | 1954 |
| Hair: | Black |
| Eyes: | Brown |
| State id: | 00231937 |
| SO#: | 232325 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Citizen: | UNITED STATES |
| Booking number: | 0413990 |
| Booking date: | Jun 9, 2004 |
| Release date: | Jun 12, 2004 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,850 |
| Number: | 04TR03837 |
| Amount: | $1,500 |