| Date of birth: | 1937 |
| Hair: | Gray or partially gray |
| Eyes: | Hazel |
| State id: | 541906 |
| SO#: | 40863 |
| Booked at: | SALT LAKE |
| Cob: | Ohio |
| Booking number: | 0127088 |
| Booking date: | Nov 4, 2001 |
| Release date: | Nov 4, 2001 |
| Booking location: | Salt Lake County, UT |
| Number: | 011103422 |
| Amount: | $5,000 |