| Date of birth: | 1955 |
| Hair: | Black |
| Eyes: | Hazel |
| State id: | 643675 |
| SO#: | 272702 |
| Booked at: | SALT LAKE |
| Cob: | New York |
| Citizen: | UNITED STATES |
| Booking number: | 0315108 |
| Booking date: | Jun 15, 2003 |
| Release date: | Jun 15, 2003 |
| Booking location: | Salt Lake County, UT |
| Amount: | $2,405 |