| Date of birth: | 1920 |
| Hair: | Gray or partially gray |
| Eyes: | Brown |
| State id: | 092138 |
| SO#: | 41588 |
| Booked at: | SALT LAKE |
| Cob: | Utah |
| Booking number: | 9723936 |
| Booking date: | Oct 22, 1997 |
| Release date: | Oct 23, 1997 |
| Booking location: | Salt Lake County, UT |
| Amount: | $1,000 |