| Date of birth: | 1931 |
| Hair: | Brown |
| Eyes: | Brown |
| State id: | 303647 |
| SO#: | 159662 |
| Booked at: | SALT LAKE |
| Cob: | Missouri |
| Booking number: | 9410885 |
| Booking date: | Jun 15, 1994 |
| Release date: | Jun 16, 1994 |
| Booking location: | Salt Lake County, UT |
| Amount: | $50 |
| Number: | 921015360 |
| Amount: | $250 |