| Date of birth: | 1945 |
| Hair: | Sandy |
| Eyes: | Blue |
| SO#: | 279132 |
| Booked at: | SALT LAKE |
| Cob: | Arizona |
| Citizen: | UNITED STATES |
| Booking number: | 0406338 |
| Booking date: | Mar 12, 2004 |
| Release date: | Mar 13, 2004 |
| Booking location: | Salt Lake County, UT |
| Number: | 04TR01670 |
| Amount: | $1,500 |